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HEDIS® MY2025: Train Smarter, Not Harder.
HEDIS Doesn’t Have to Feel Like a Sprint
The mad dash of HEDIS reporting for Measurement Year (MY) 2024 is over, and after months of audits, medical record reviews, and data submission, many are eager for a well-earned break. But now’s not the time to collapse at the finish line; it’s time to train for the next race — and run it smarter.
Too often, health plans approach HEDIS like a frantic sprint. But in reality, it’s a year-long marathon, and the teams that prepare methodically end up stronger and happier at the finish.
This guide will help you pace yourself for HEDIS MY2025 with a clear strategy, healthy tech stack, and the right training partners by your side.
Set Your Sights on the Course Ahead:
Know the Industry Changes
NCQA continues to evolve HEDIS to reflect modern care delivery and data collection methods. Understanding these changes now can help you avoid surprises later.
NCQA rule changes: Know what’s coming
Stay on top of NCQA’s proposed updates and keep an eye out for requests for public comments — they’re your chance to weigh in and prepare for changes before they hit.
Digital measures implemented for MY2025
The transition to digital reporting continues in MY2025. Four additional measures will now be collected via Electronic Clinical Data Systems (ECDS):
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Eye Exams for Diabetics (EED)
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Childhood Immunization Status (CIS)
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Immunizations for Adolescents (IMA)
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Cervical Cancer Screening (CCS)
Post Race Debrief:
Evaluate Your MY2024 Performance
Use the post-season window to assess what worked and where gaps remain.
Vendor management and oversight
If your team is juggling too many point solutions, it might be time to consolidate. Fewer vendors equals fewer handoffs, less confusion, and a smoother stride.
Analytics that keep pace
Make sure that your quality analytics platform is able to deliver timely insights that support focusing your efforts where they’ll matter most.
- Was your quality vendor able to deliver timely insights?
- Did they provide responsive support during crunch time?
Data integration and medical record retrieval
Evaluate your data integration and medical record retrieval processes for efficiency, support of timely reporting, and completeness.
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Were your ETL pipelines efficient enough to support timely reporting?
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Did you have access to accurate, real-time data when it mattered most?
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Was your medical record retrieval fast and reliable? Could you consistently locate needed medical records to close care gaps?
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Did you have a central location to store and access your data? How much time did you spend transferring and extracting data?
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Should you explore adding supplemental data collection channels?
Team Evaluation: Gauge Your Resources and Readiness
Now’s the time to assess whether your internal resources are prepared for another heavy lift.
Staffing and expertise
Do you have the right people, or do you need to add additional resources for the upcoming year? If you’re expanding your hybrid review projects, do you need more nurse reviewers or temp staff to support?
Training and development
Consider implementing or expanding training programs now, before the January rampup begins to help build up confidence and agility.
Data security
Don’t trip on security lapses. Now is the time to shore up your data protection protocols and security certifications to limit the chances of a data breach.
Clean Up Your Stats: Assess Data Quality
Poor provider data leads to failed chases, missed opportunities, and lower scores. Invest time now in a cleanup project.
Provider data
HEDIS success depends on clean, complete, and standardized data.
- Were phone numbers, addresses, and faxes accurate, complete, and in a standardized format?
- Was your reporting impacted by missing or incomplete data?
Indirect Supplemental data
Your supplemental data strategy should maximize impact and minimize wasted effort.
- Are your supplemental data sources delivering meaningful returns on investment?
- Do you need to identify additional data sources before the next measurement season?
Train Year-Round: Get Proactive
Don’t wait for January to hit the track. The strongest teams train in the off-season.
Run prospective measure rates
Use prospective analytics to identify opportunities to improve documentation and care delivery.
Year-round medical record review
Don’t wait until it’s crunch time. Run a mock MRR project to clean up and standardize provider data and refine chase logic based on upcoming measure changes. Conducting this type of proactive review helps ensure you’re directed to the proper medical record the first time around.
Work with your auditor early
Get ahead of the game and engage with your auditor early. Give them ample time to review and approve any system, vendor, or data updates before the starting gun fires.
Your off-season checklist
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Review NCQA measure changes and public comment periods
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Prepare for digital ECDS reporting
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Evaluate vendor performance and tech tools
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Assess staff capacity and training needs
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Scrub and standardize provider data
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Run prospective measure rates
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Launch a mock MRR project
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Sync with your auditor
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Schedule time with Inovalon to plan your 2026 strategy
Inovalon works with 15 of the top 15 U.S. health plans1
25 years of NCQA HEDIS Measure Certification2
Pass the Baton: This Doesn’t Have to Be a Solo Run
HEDIS season can be exhausting, but it doesn’t have to be a one-person race.
With Inovalon as your partner, you’re not sprinting alone, you’re part of a relay team. We help carry the baton when the race gets intense — whether it’s accelerating data retrieval, boosting analytics accuracy, or supporting your staff. Having a partner in your corner with the experience and expertise to handle all phases of the HEDIS reporting season helps relieve the pressure of this time of year.
Together, we cross the finish line faster, smarter, and with fewer blisters.
Relief is Possible — With the Right Partner in Your Lane
Post-HEDIS summer and early fall can be your best opportunity to drive improvements and avoid fire drills next year. Whether it’s consolidating vendors, investing in analytics, retraining your team, or cleaning your data, a little work now can mean a lot less chaos later.
Let’s make HEDIS MY2025 the season you stop sprinting and start cruising.
See how Inovalon can support you during HEDIS season.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)
1.Top 15 health plans based on AIS List of Top U.S. Payers, Sept. 2025. Inovalon internal reporting based on Q2 2025 enrollment data, October 2025.
2. “Inovalon’s Converged Quality Achieves 25th Consecutive NCQA HEDIS® Certification,” Inovalon, July 31, 2025, https://www.inovalon.com/news/inovalons-converged-quality-achieves-25th-consecutive-ncqa-hedis-measure-certification/
3. Inovalon calculation based on HEDIS® MY2024 data. January 2025.
Inovalon and design® and Inovalon® are trademarks of Inovalon, Inc.
