Outcomes & Evidence
HDIM provides transparent measure logic, audit-ready reporting, and a clear methodology for outcomes tracking. Client-validated results are available on request.
HEDIS Measure Coverage
Representative measures with standardized gap definitions
| Measure | Category | What We Track |
|---|---|---|
CDC - HbA1c Control A1c control and monitoring for members with diabetes | Diabetes Care | Standardized gap definition, denominator logic, and outreach readiness |
CBP - Blood Pressure Blood pressure control and measurement adherence | Cardiovascular | Standardized gap definition, denominator logic, and outreach readiness |
BCS - Breast Cancer Screening Screening completion and outreach readiness | Preventive Care | Standardized gap definition, denominator logic, and outreach readiness |
COL - Colorectal Screening Screening compliance and gap closure workflows | Preventive Care | Standardized gap definition, denominator logic, and outreach readiness |
TRC - Transitions of Care Post-discharge follow-up and care coordination | Care Coordination | Standardized gap definition, denominator logic, and outreach readiness |
FUM - Follow-Up Mental Health Timely follow-up and behavioral health engagement | Behavioral Health | Standardized gap definition, denominator logic, and outreach readiness |
ROI & Business Case
We build a custom ROI model using your baseline performance, measure mix, and member population. The model highlights the largest value levers and the operational changes required to realize them.
- • Reduced manual measure calculation and reconciliation
- • Earlier gap detection for preventive and chronic care
- • Quality incentive protection and audit readiness
- • Care management prioritization with measurable impact
Get a Customized Model
Share your program goals and we'll deliver a tailored ROI and implementation plan.
Request ROI AnalysisCustomer Success Stories
Note: Client-validated outcome briefs are available on request and tailored to your measure mix, baseline performance, and care management model.
Medicare Advantage Plan
Built a standardized gap-closure workflow tied to HEDIS, Stars, and member outreach operations.
Academic Medical Center
Integrated inpatient, outpatient, and post-acute data to coordinate transitions of care.
Multi-Specialty Group
Unified measure tracking for MIPS, quality contracts, and internal performance targets.
Industry Standards & References
HDIM is built on industry-standard specifications and best practices from leading healthcare organizations.
HEDIS Measures and Technical Specifications
National Committee for Quality Assurance (NCQA) • 2024
Official HEDIS measure specifications used for CQL-based quality evaluation in HDIM.
FHIR R4 Specification
HL7 International • 2023
The FHIR R4 standard that HDIM uses for clinical data interoperability via HAPI FHIR 7.x.
Clinical Quality Language (CQL) Specification
HL7 International • 2023
CQL specification enabling native quality measure logic execution without proprietary translation.
CMS Quality Reporting Programs
Centers for Medicare & Medicaid Services • 2024
Federal quality reporting requirements including MIPS, Stars, and value-based care programs.
Technical Methodology
Quality Measure Evaluation
- 1.FHIR R4 Data Ingestion: Patient data loaded as native FHIR resources.
- 2.CQL-Native Execution: HEDIS CQL definitions executed using open-source CQL tooling.
- 3.Care Gap Detection: Measure results analyzed to identify actionable care gaps per patient
- 4.Performance Reporting: Aggregated results for HEDIS submission, Stars, MIPS reporting
Performance Targets
| Metric | Target |
|---|---|
| FHIR Query Latency (p95) | <200ms |
| CQL Execution (avg) | <600ms |
| Throughput | 150/sec |
| Cache Hit Rate | >80% |
Targets vary by deployment size, data sources, and measure mix.