Komodo Health, an AI-powered healthcare intelligence company, is teaming up with the National Committee for Quality Assurance (NCQA) to modernize how healthcare quality measures are developed.
The multi-year strategic partnership will allow NCQA researchers to tap into Komodo’s Healthcare Map, made up of over 330 million de-identified patient journeys, to analyze care across insurance types, care settings and patient populations from a single longitudinal data source.
They will have access to Komodo’s Marmot, an AI-powered healthcare intelligence platform, to explore complex questions with transparent, reproducible outputs. NCQA is solely responsible for developing HEDIS measures.
“Because quality measures define how healthcare organizations understand performance and help identify where they need to improve care, having a comprehensive, current view of what is actually happening across patient populations is critical,” Web Sun, co-founder and co-CEO of Komodo Health, told Fierce Healthcare in emailed comments. “We engineered the Healthcare Map and Marmot to do exactly that.”
The goal is to allow NCQA to evaluate new measures more quickly and efficiently and to ensure HEDIS reflects real-world evidence. Developing new quality measures has historically required pulling from disparate datasets, including field testing with individual payers and other partners. This could take two to three months, and often had to be done separately for each population studied.
“Using Komodo’s Healthcare Map has greatly streamlined that process,” Tricia Elliott, VP of quality implementation at NCQA, told Fierce Healthcare in emailed comments. “Because the Healthcare Map includes insights from Medicare, Medicaid and commercial populations, our researchers can evaluate measures across multiple insurance types using a single, consistent data source rather than running separate analyses.”
Komodo already supported the development and testing of the Follow-Up After Positive Colorectal Cancer Non-Invasive Screening Test (COF-E), to be implemented in Measurement Year 2027. NCQA used lab data and claims information to understand the follow-up rate after a positive result on a stool-based screening test. Testing time was cut nearly in half, per Elliott, taking about a month for Medicare Advantage, Medicaid and commercial populations.
Looking ahead, NCQA hopes to advance HEDIS measures tested against real-world patterns of care that are actionable for organizations. “We have confidence in Komodo’s Healthcare Map because of its breadth, consistency and longitudinal coverage,” Elliott said.
The Healthcare Map is not static, Sun said. Komodo continuously refines it and aims to increase its breadth, depth and longitudinal view of healthcare delivery. “But expanding the data is only part of the opportunity. We’re also focused on helping organizations turn that data into trusted intelligence to inform their most important decisions,” Sun noted.
“We expect Komodo to serve as a key platform supporting HEDIS measure testing activities across our portfolio,” Elliott said. “While specific testing approaches will continue to be driven by the needs of individual projects, our objective is to leverage this capability broadly to support testing for ongoing measure innovation, maintenance and evaluation.”