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Highmark Inc. Chooses Verisk Health to Streamline Its Quality Measurement and Reporting

Verisk Health’s HEDIS reporting suite completes NCQA certification and continues its long-standing position as a NCQA beta-testing solution
December 15, 2010

WALTHAM, Mass. – Verisk Health announced today that Highmark Inc. has selected SightlinesTM Performance Measurement to manage its Healthcare Effectiveness Data and Information Set (HEDIS®) processing and reporting initiatives.  Verisk Health is a global leader in identifying, analyzing, and predicting healthcare risk.  Highmark, an independent licensee of the Blue Cross Blue Shield Association, is a leading health insurer that serves 4.7 million people through the company’s healthcare benefits business.

“Focusing efforts towards the achievement of improved HEDIS scores is imperative in fulfilling our mission to be the leading health and wellness company for the regions that we serve.  Demonstrating strong clinical performance outcomes is essential to retaining and attracting new membership,” said Robert Callahan, quality improvement and compliance consulting practice leader of enterprise informatics at Highmark.  “Sightlines Performance Measurement will enable Highmark to simplify the HEDIS reporting process and improve key metrics by allowing us to baseline performance and develop proactive strategies for improving care services.”

Highmark will use Sightlines Performance Measurement for all its HEDIS measurement and reporting needs.  This includes aggregating claims data and analyzing measures to assess compliance rates and improve clinical results before the June 2011 submission deadline.  Verisk Health is certified by the National Committee for Quality Assurance (NCQA) for those measures and is a long-standing beta test associate with the standards organization.

 “Verisk Health is pleased to expand its relationship with an organization like Highmark that is dedicated to providing accessible, affordable, and high-quality care to its members,” said Mike Coyne, president of Verisk Health.  “And we’re pleased to provide the software to our clients so early in preparation for the reporting season.  We’re confident that our development and quality assurance efforts have resulted in an outstanding product for Highmark and all our clients.”

Verisk Health’s quality measurement and reporting solution enables managed care organizations to quickly and easily view results for each HEDIS measure, sample, and chase calculation performed.  Key uses of the product include:

  • calculating HEDIS measures from source healthcare data
  • analyzing HEDIS data using robust filters, drills, and reports
  • collecting hybrid medical record data
  • developing custom measures for clinical reporting initiatives

Highmark is one of more than two dozen new and renewal contracts recently signed by Verisk Health for its HEDIS® reporting suite.  The payor organization is a long-time user of Verisk Health’s Sightlines DxCG Risk Solutions, a risk-adjustment and predictive modeling toolset.  In recent months, Verisk Health has also signed contracts with leading provider organizations that will use Sightlines Performance Measurement to assess and demonstrate physician accountability and compliance to clinical standards.

About Verisk Health
Verisk Health, a subsidiary of Verisk Analytics, leverages healthcare data to help businesses and governments understand their medical and financial risk for the purpose of managing costs and clinical outcomes more effectively.  Through the combination of leading predictive science, the finest evidence-based clinical engine, and superior technology, we have created the most extensive independent risk assessment and decision analytics platform in the healthcare industry.  Our primary focus is to identify actionable strategies for managing healthcare costs and quality at both the individual and population levels.  We consistently research, evaluate, and invest in our business to ensure that we remain leaders in our industry and the most efficient and effective solution for our clients.  For more information, please visit www.veriskhealth.com.

About Highmark Inc.
As one of the leading health insurers in Pennsylvania, Highmark Inc.’s mission is to provide access to affordable, quality healthcare enabling individuals to live longer, healthier lives. Based in Pittsburgh, Highmark serves 4.7 million people through the company’s healthcare benefits business. Highmark contributes millions of dollars to help keep quality healthcare programs affordable and to support community-based programs that work to improve people’s health. Highmark exerts an enormous economic impact throughout Pennsylvania. A recent study states that Highmark’s positive impact exceeded $2.5 billion. The company provides the resources to give its members a greater hand in their health.
Highmark Inc. is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. For more information, visit www.highmark.com.

HEDIS® is a registered trademark of the NCQA.

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