SSI’s HEDIS quality measures are validated against real patient data, resulting in greater accuracy, clinical relevance, and confidence that metrics truly reflect real-world care standards and patient outcomes.
Improve data collection, care gap identification, and outcomes.

Identify missing screenings, unscheduled follow-up visits, and preventive care opportunities before reporting deadlines.
Automate the collection of clinical and claims data for more complete and precise quality assessment.
Capture compliant, standardized data, with claims-to-FHIR bundles and streamline interoperable data exchange.
Monitor performance trends and high-risk populations with clear analytics and monthly measure reporting.

QM Optimizer Elite for Providers streamlines care gap identification and clinical data exchange to optimize quality measurement and simplify data sharing for payer HEDIS reporting.
It collects claims and external clinical data from your preferred QHIN and delivers monthly quality measure results for proactive intervention. Providers can also monitor trends and identify high-risk patients from an intuitive analytics platform with visual insights.

QM Optimizer Elite for Payers automates collection of complete clinical and external claims data. It connects seamlessly to your preferred QHIN to capture essential clinical records and combine them with out-of-network claims data for a fuller view of member care.
Monthly performance ratings are digitally calculated using NCQA’s CQL engine and delivered in flexible formats like JSON (FHIR®), CSV, and Excel. The solution also generates claims-to-FHIR bundles, transforming raw claims into structured, interoperable data that includes patient, provider, and service details.

SSI is at the forefront of healthcare innovation, validating digital quality measures with actual patient data, focusing on the CMS Stars and Medicaid priorities most critical to value-based care performance.
SSI leverages NCQA Digital Content Services to offer digitalized FHIR® CQL HEDIS® measures, to simplify compliance and quality measurement.

Whether you’re a provider or payer, identify the solutions that best align with your organizational needs.
Quality measurement is part of SSI’s Clinical Data Solutions suite that enables efficient data exchange to improve care coordination.
SSI’s HEDIS quality measures are validated against real patient data, resulting in greater accuracy, clinical relevance, and confidence that metrics truly reflect real-world care standards and patient outcomes.
SSI supports quality measures most critical to value-based care performance, with more in development.
You can view your quality measures data through the QM Optimizer HQ Insights platform. HQ Insights gives you an intuitive analytics dashboard where you can track population-level data, monitor trends, and explore visual insights—all in one place.
QM Optimizer Elite integrates with care management, network performance, and population health systems.

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