MEDecision Achieves NCQA HEDIS Certification for First Care Opportunities Software

Alineo Clinical Intelligence Recognized by Leading Healthcare Quality Assurance Organization for Ability to Identify Gaps in Care

WAYNE, Pa.--(BUSINESS WIRE)-- MEDecision, Inc., a leading provider of collaborative healthcare management solutions, has earned the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS®) Software Certification for its programs that identify “care opportunities.”

NCQA is an independent, not-for-profit organization dedicated to measuring the quality of America’s healthcare. Since its introduction in 1993, HEDIS has evolved to become the gold standard in managed care performance measurement.

Alineo® Clinical Intelligence Rules 2.4.0 and 2.5.0 have met NCQA HEDIS Care Opportunity software standards. Alineo is MEDecision’s collaborative healthcare management platform for delivering outcome-driven case, disease and integrated utilization management. Alineo Clinical Intelligence identifies populations of health plan members most likely to benefit from interventions, or “care opportunities,” according to evidence-based medicine and best practices. NCQA Software Certification signifies that the populations identified for care opportunities by Alineo Clinical Intelligence are aligned with NCQA quality measures.

“We are confident in our solution’s ability to produce accurate and reliable results and are honored to earn NCQA software certification,” said Andrew P. Schuyler, MD, the company’s executive vice president and chief medical officer. “This is a significant testament to MEDecision’s commitment to quality and clinical integrity.”

“Plans that use NCQA-certified software can spend more time improving quality in ways that matter to their members and less time getting ready for an audit,” said Mary Braman, NCQA’s director of licensure and certification. “We commend the vendors who have earned certification for their commitment to quality.”

“MEDecision recognizes that continuous quality improvement as well as setting a high benchmark of excellence is of significant importance to our customers,” Schuyler said. “That is why we are so proud to have achieved this designation.”

NCQA validates software by generating unique sets of test data that vendors process using their software. The output is compared to the expected results to determine if the software computes results according to the specifications.

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About NCQA

Celebrating its 20th anniversary in 2010, NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA’s Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers.

About MEDecision

MEDecision offers collaborative healthcare management solutions that provide a simple and smart way for payers and providers to harness the power of knowledge to enable the best clinical decisions and improve health outcomes. Designed around a patient-aware health management philosophy, MEDecision’s solutions include Alineo®, a collaborative healthcare management platform for delivering outcome-driven case, disease and utilization management; Nexalign®, a collaborative healthcare decision support service that fosters better payer-patient-physician interactions; and InFrame™, a collaborative health information exchange service that connects care delivery organizations with one another and their patients. For more information, visit

MEDecision is a trademark of MEDecision, Inc. The MEDecision logo and product names are also trademarks or registered trademarks of MEDecision, Inc. Other product and brand names are trademarks of their respective owners.

HEDIS™ is a registered trademark of the National Committee for Quality Assurance (NCQA).

Tags: MEDecision, clinical intelligence rules, HEDIS, healthcare, healthcare reform, collaborative healthcare management, NCQA, NCQA certification, care opportunities, gaps in care, healthcare quality


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