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.
Healthcare Quality Measurement
Digital Quality Measurement
Improve data collection, care gap identification, and outcomes.
Improve Care with Better Data
Turn fragmented data into insights that help improve value-based care performance.
Close Care Gaps Faster
Identify missing screenings, unscheduled follow-up visits, and preventive care opportunities before reporting deadlines.
Improve Measurement Accuracy
Automate the collection of clinical and claims data for more complete and precise quality assessment.
Simplify Data Sharing
Capture compliant, standardized data, with claims-to-FHIR bundles and streamline interoperable data exchange.
Increase Visibility
Monitor performance trends and high-risk populations with clear analytics and monthly measure reporting.
QM Optimizer Elite for Providers
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
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.
Driving Healthcare Transformation and Innovation
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.
Built to Advance Care Quality
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Quality Measurement
Frequently Asked Questions
SSI supports quality measures most critical to value-based care performance, with more in development.
- Adult Immunization Status
- Breast Cancer Screening
- Cervical Cancer Screening
- Childhood Immunization Status
- Colorectal Cancer Screening
- Utilization of the PHQ-9 to Monitor Depression Symptoms for
- Adolescents and Adults
- Glycemic Status Assessment for Patients With Diabetes (formerly HBD)
- Immunizations for Adolescents
- Kidney Health Evaluation for Patients With Diabetes
- Osteoporosis Screening in Older Women
- Diabetes Monitoring for People With Diabetes and Schizophrenia
- Controlling High Blood Pressure
- Osteoporosis Management in Women Who’ve Had a Fracture
- Follow-Up After Emergency Department Visit for People With Multiple
- High-Risk Chronic Conditions
- Follow-Up After Emergency Department Visit for Substance Use
- Follow-Up After Emergency Department Visit for Mental Illness
- Blood Pressure Control for Patients With Diabetes
- Lead Screening in Children
- Chlamydia Screening in Women
- Prenatal Immunization Status
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.
Quality Measurement Resources
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Five Cost-Cutting Tips for Health Plans
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Disruption to Efficiency: How a Payer Transformed Healthcare Claim Processing with SSI
Read More About Disruption to Efficiency: How a Payer Transformed Healthcare Claim Processing with SSI -
Strengthening Preventive Care with Digital Quality Measurement for Healthcare Plans and Providers
Read More About Strengthening Preventive Care with Digital Quality Measurement for Healthcare Plans and Providers -
Health Plan Cost Reduction: Five Strategic Plays for Commercial Payers
Read More About Health Plan Cost Reduction: Five Strategic Plays for Commercial Payers -
Costly Claim Operations Breakdowns Smaller Health Plans Can’t Ignore
Read More About Costly Claim Operations Breakdowns Smaller Health Plans Can’t Ignore -
The SSI Group Brings an Immersive Revenue Cycle Experience to HFMA Annual Conference 2026
Read More About The SSI Group Brings an Immersive Revenue Cycle Experience to HFMA Annual Conference 2026
Transform Your Revenue Cycle
Discover how The SSI Group’s healthcare revenue cycle solutions can help you increase efficiency and improve financial outcomes.
