Digital Quality Dispatch: December

Resources for health care leaders on their digital quality journey

December Newsletter: Year End Reflection

This month’s newsletter is a bit different - we’re taking a step back from the usual updates on all the cool things we’ve been up to and instead reflecting on 2024 with insights from our CEO and CTO, Rebecca Jacobson and Girish Chavan . It’s been a year shaped by a series of macro and micro shifts in the healthcare landscape, prompting us to revisit key lessons from 2024 while also exploring expert perspectives on what lies ahead. Whatever 2025 brings, we at Astrata, Inc are here to support health plans on their digital quality transformation journey.

Industry Review: The healthcare industry & digital quality in 2024

A year of Progress, Milestones, and Foundations

Several key events this year have accelerated the pace of digital transformation. According to Jacobson, “Health plans now have more crucial information to support their transitions, thanks to NCQA 's technical and regulatory timelines. These include the retirement of the hybrid method (2029), the alignment of digital measures with the traditional release cycle (2025), and the anticipated IDSS-based reporting mechanism (late 2025). Additionally, the licensing process for these new measures is becoming clearer, positioning health plans to prepare and advance their strategies. At Astrata, we’re seeing more plans begin to focus on this, especially as they start educating themselves and reaching out to partners like us,”

Industry milestones in 2024

• Growing adoption of Prospective HEDIS, often supported by NLP, enabling fully prospective workflows.

• Improved use of diverse clinical data from HIEs, the Epic Payer Platform, and other EHR vendor-based methods.
• Increased focus on TEFCA, QHIN, and interoperability, with questions about how Digital Quality fits into these programs.
• Health plans are beginning to transition to digital measures, aligning these efforts with existing interoperability initiatives.

Digital Quality – Health Plans Review: Digital transformation among health plans in 2024

At Astrata, we’ve had the privilege of working alongside many forward-thinking plans and thus observing & analyzing best practices in the digital transformation journey. We find that?access to clinical data is the key differentiator for advanced health plans.

?“Only a few fully grasp how critical this will be - not just for quality, but for every aspect of their operations. Those leading the way are taking a broad, strategic approach to this challenge,” Jacobson explained.

For a more in-depth analysis, please visit our latest blog:

CMS Star Ratings in 2024

Many plans were caught off guard by the significant changes in last year’s CMS Star Ratings, including widespread drops in ratings and quality bonus payments. These shifts, driven by the long-anticipated implementation of Tukey outlier detection, still surprised many.

Next Steps for Health Plans in 2025

• Establish a comprehensive enterprise clinical data strategy
• Create a roadmap for transitioning to digital measures
• Start moving your team toward prospective HEDIS reviews

Astrata Achievements in 2024

A Year of Innovation, Recognition, and Progress

That’s how our Co-founder and CTO, Girish Chavan , sums up 2024 from the leadership team’s perspective. And no Year in Review is complete without reflecting on our growth, patting ourselves on the back, and gearing up for the year ahead. At Astrata, we remain committed to staying responsive to change, anticipating potential challenges, and continuing to adapt our solutions to meet the evolving needs of health plans.

So, what did we achieve last year?

Chart Review 2.0

This year marked a significant leap forward for Astrata and our flagship Chart Review product.

Spring brought our biggest update yet with Chart Review 2.0 that included:

• A refreshed abstraction screen with faster navigation and the autofill feature, cutting abstraction time dramatically.
• A fully revamped Reports module featuring strategic dashboards for prospective HEDIS oversight, including opportunity tracking, team workloads, accuracy, and productivity metrics.

In Fall, we were thrilled to announce that Chart Review was awarded the DiMe Seal by the Digital Medicine Society (DiMe) , recognizing our unwavering commitment to building high-quality, trusted digital health software.

HITRUST Certification

We take safeguarding our customers' data seriously, with patient privacy at the core of everything we do. This commitment led us to achieve HITRUST r2 Certification—the highest level of information protection and compliance assurance certification offered by HITRUST .

Looking Ahead to 2025

Since launching Chart Review in 2021, Astrata has redefined what’s possible for HEDIS abstraction. Now, we’re doing the same for our eMeasure Digital Quality engine. In 2025, we’re rolling out major updates that harness the full potential of FHIR and CQL technologies. These innovations will deliver unique benefits and reimagine how HEDIS operations are supported.

Outlook & Expert Predictions for 2025

As the final weeks of 2024 approach, we want to close the year with momentum. At Astrata, that means preparing for what lies ahead - continuing to learn, understanding our position, driving innovation, and taking action when the time is right. For the final few questions, we turned to both of our leaders, Rebecca Jacobson and Girish Chavan , to hear their thoughts on the upcoming year and their recommendations for health plans.

Main Theme of 2025: On your mark, get set… and GO!

Health plans are facing increasing pressure to do more with less, driving the need for scalable solutions to support members effectively. Jacobson sees this as a pivotal moment for digital quality transformation.

"Health plans continue to find themselves in challenging times, needing to build towards more sustainable, scalable methods for supporting their members without necessarily adding more staff," she noted. "We see this in quality too, and this is one of the reasons why the timing is good for the digital quality transition. I also think we’ll see plans looking for value from interoperability efforts, and quality is one area where they’ll find it."

Echoing this sentiment, Chavan also expects NCQA to lay the final groundwork for a complete transition to digital quality reporting in the upcoming year. "Interest among health plans is already growing, and I expect momentum to accelerate in 2025,” he said.

Thus, they believe forward-thinking health plans will lead the way by:

• Investing in acquiring new clinical data sources.
• Mapping their data to FHIR standards to enable seamless digital quality reporting.

The future belongs to those who embrace this transformation early.

Guidance for health plans

Astrata has introduced a Digital Quality Maturity Model - a phased approach designed to guide health plans on their journey to digital quality success.

To prepare for the 2030 transition, health plans should:

1. Start Early: Focus on understanding the data requirements for digital quality reporting.
2. Assess Readiness: Identify gaps in your current infrastructure and data landscape.
3. Take Incremental Steps: Follow a phased strategy to build maturity and ensure a smooth transition.

Plans that begin their digital quality journey in 2025 will be best positioned to adapt, thrive, and lead the way by 2030.

For a deeper dive, read our blog here:

How can we help?

Astrata’s eMeasure product is one of the first native FHIR+CQL engines, purpose-built to help health plans transition seamlessly to digital quality operations.

Through our client engagements, we’ve established a clear set of maturity stages to guide health plans as they advance from Traditional HEDIS? to Digital HEDIS?.

Our approach combines:

• Technical and Data Readiness: Preparing systems and data infrastructure for digital quality.
• Sandbox Testing: Offering a sandbox environment to build confidence and expertise before the full transition.

By leveraging this phased strategy, health plans can limit tech investment during the interim period of maintaining multiple engines while ensuring a smooth, efficient switchover.

Astrata, Inc is here to help health plans embrace the future of digital quality with confidence and clarity.

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