SSI Group and KONZA Health Advance Digital Quality Measurement Automation
December 17, 2025
As healthcare stakeholders sharpen their focus on value-based care, The SSI Group, LLC (SSI) and KONZA Health have made data exchange between payers and providers more efficient. The combined expertise produced a solution that makes it easier to access clinical and claims data and stay ahead of compliance requirements.
Long-term Partnership with a Bold Vision
SSI, a leading revenue cycle management company and KONZA Health, a nationwide health information exchange and Qualified Health Information Network (QHIN), first began partnering over 14 years ago to streamline health information sharing with interoperability solutions for better care coordination.
The latest collaboration is Quality Measure Optimizer EliteSM (QM Optimizer Elite). This automated solution seamlessly merges clinical data from KONZA and claims data from SSI, offering real-time, actionable insights that drive performance tracking and improvement across the care continuum.
Recognized by NCQA for Innovation and Impact
Vik Wadhwani, Chief Product and Transformation Officer of The National Committee for Quality Assurance (NCQA) praised the KONZA Health and SSI partnership at the 2025 Health Innovation Summit, underscoring the value of the collaboration in advancing digital quality measurement.
“KONZA Health shows what’s possible when purpose drives innovation. In partnership with The SSI Group, LLC, they are implementing a fully digital operational measurement capability—without relying on traditional HEDIS infrastructure. By merging clinical and claims data into a unified patient history, they’re working to deliver digital quality insights directly at the point of care. It’s a compelling example of progress in action.”
Key Features of QM Optimizer Elite:
- Automated claims and clinical data aggregation and standardization
- Data Aggregator Validation (DAV) accredited clinical data bundles
- Monthly digital HEDIS® ratings powered by NCQA’s CQL engine in multiple formats, including FHIR®
- Reduced administrative burden that occurs from manual chart collection and report generation
- Analytics platform with insights that help care teams identify care gaps, prioritize outreach, and monitor performance
With QM Optimizer Elite, users in value-based care arrangements can reduce administrative burdens associated with collecting data and calculating quality measures.
“Through our partnership with SSI, we’re turning disparate data into reliable digital quality insights that help payers and providers deliver better care, faster,” stated Laura McCrary Ed.D., President and CEO at KONZA Health.”
Simplifying Compliance and Boosting Quality Scores for Payers
SSI and KONZA Health are helping payers meet federal mandates and elevate value-based care performance to drive higher ratings.
Annual HEDIS reporting can be a heavy lift, especially for small and mid-size health plans. A key reason why SSI Group and KONZA Health launched QM Optimizer Elite was to make the process smoother, smarter, and far less stressful for health plans with limited IT resources.
With KONZA Health’s Data Aggregator Validation (DAV) accredited clinical data and SSI’s powerful claim and encounter FHIR data integration technology, payers get a turnkey solution that checks all the HEDIS boxes without needing to build and maintain complex systems in-house.
And the benefits for payers go beyond meeting digital quality measurement mandates:
- Reporting gets faster and easier: Monthly digital HEDIS ratings mean no more year-end crunch. Payers get a clear picture of performance all year long.
- Care gaps close sooner: Real-time data access and insights enable interventions that close care gaps well before HEDIS deadlines.
- Less manual work: Slow and costly chart-chasing is eliminated, making overhead expenses come down.
- Better data, better decisions: Broader exchange of clinical and claims data means more comprehensive quality measurement, better provider coordination, earlier interventions and faster care gap closures.
- Higher ratings and CMS Stars: Better quality scores leading to stronger value-based care performance and better reimbursement opportunities.
Unlike many digital quality measurement solutions, QM Optimizer Elite is leading the way in healthcare innovation. SSI is validating digital quality measures using actual patient data with the help of physician and nurse informaticists, focusing on HEDIS and CMS Star priorities most critical to value-based care performance.
A Shared Commitment to Advancing Value-Based Care
SSI and KONZA Health are united by a mission to invest in solutions that promote efficient data exchange to drive better health and financial outcomes, and quality measurement integrity is essential.
Katrina Parrish, MD, FAAFP Chief Medical Information Officer at SSI explains, “This isn’t just about delivering healthcare tech, it’s about working together to solve real problems, with the flexibility to evolve as the healthcare environment and customer needs change…with physician and nurse informaticist support, the quality process is optimized.”
While the partnership grows, QM Optimizer Elite will be improved with new capabilities and an expanding library of validated HEDIS measures. Progress will also be fueled by real-world feedback from payers and providers that are using the product for digital quality measurement and proactive care gap closure.
To learn more about QM Optimizer Elite or to request a demo, visit thessigroup.com.
To learn more about KONZA Health, visit konza.org.
References
1Under the Federal Trusted Exchange Framework Common Agreement (TEFCA)
2Fast Healthcare Interoperability Resources
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