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Certified HEDIS® and Hybrid Measures Solution

Certified HEDIS® and Hybrid Measures Solution

Solution Overview

MedHOK’s comprehensive, end-to-end HEDIS® solution supports all aspects of commercial, Medicare and Medicaid lines of business for both administrative and hybrid measures. Fully integrated with MedHOK’s Care Management, Disease Management, Utilization Management, Appeals and Grievences components, our HEDIS® solution provides the ONLY fully integrated solution on the market. As opposed to most other vendors offering HEDIS® solutions, MedHOK has designed its solution to be business-user configurable, and clients have total control of the solution. After integration and implementation, clients can choose to run HEDIS® as often as they like to target, monitor, and remediate care gaps year-round. MedHOK holds full National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) Software Certification™.

HEDIS Care Gap Provider COR Scorecard

  • Provider COR Scorecard “standard 360”
  • Accessible from member compliant and non-compliant reporting
  • Details provider demographic information for provider targeting and outreach
  • Outlines target measure supporting organization
  • Outlines all members that impact organizations’ target measure
  • Export for manual outreach and provider relations field work
  • May be use for auto-generated outreach campaigns
  • Alternative view OOB Provider COR Scorecard global stratification
  • Both views may be uploaded to provider portal
  • OOB Provider COR Scorecard stratified based on provider prioritization of provider with the greatest impact to clients reporting and meeting of target goals
  • Reflects member hierarchy listing members in order of greatest impact to target measures

Customers use this solution to:

  • Improve quality outcomes by addressing quality initiatives through strong care management processes
  • Improve healthcare initiatives using automated structured workflows and functions to manage member care
  • Improve population health management by stratifying at-risk populations and defining and executing programs to effectively manage their care

Have You Considered …

With Certified HEDIS® and Hybrid Measures Solution, you may also want to manage related functionalities on one platform to ensure compliance, improve efficiency and productivity, and deliver better quality care. Consider adding these MedHOK solutions:

Care Management
Care Gaps
Star Quality Measures


MedHOK has enabled 50 of the largest and highest rated health plans to successfully pass HEDIS® audits year over year


Utilize the most comprehensive evidence-based risk adjustment platform to stratify populations and drive effective care management improvements


MedHOK holds three NCQA® certifications: HEDIS®, Pay for Performance and Disease Management, and has fully integrated Pharmacy Quality Alliance (PQA) drug measures

Request a Demo

See How the Industry’s Top Rated Health Plans Use MedHOK’s Certified HEDIS® and Hybrid Measures Solution.

Please complete the form and let us know which capabilities you would like to see. One of our demo specialists will contact you to schedule your custom demo.

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