Compliance Reporter

A robust reporting and workflow management tool for payers that want to streamline and increase their Healthcare Effectiveness Data and Information Set (HEDIS®) quality measurement and reporting activities.


AmplifyYour HEDIS Activities

  • Simplify the complete hybrid review process through our NCQA-certified HEDIS quality rules processing engine. Generate samples, manage medical record abstractions, and create data submission files.
  • Support medical record review activities with online data collection. Central data repository holds claims, membership, enrollments, lab, and pharmacy data, plus scanned charts.
  • Use web-based workflows to allocate chart reviews manually or systematically by location. Isolate measure-level and member-level detail for further research using powerful audit tools.
  • Eliminate time-consuming manual coding and measure updates with automated processes. Certify final hybrid rates within minutes, rather than days.
  • Increase efficiency throughout the HEDIS lifecycle. Create your CAHPS® survey sample frame in a few clicks. Manage both your HEDIS and analytics drawing from the same input files, with Risk Manager.
  • Receive up-to-the-minute results with in-line rate calculation. Quickly generate NCQA IDSS data files, the CMS-required PLD submission file, and Medicare patient-level data for final submission.


Simplified Collection, Review, Submission, and Reporting

  • Systematic medical record review

    • Improve data integrity with a centralized data repository, updated with the latest compliance details. Manage the entire medical record review process with single-source, clean data.
    • Streamline chart review with web-based workflows, including management chart review and chart chase management. Flexible task assignments accommodate various workflows to speed the process.
    • Stay on track with HEDIS process productivity summary, which includes measure status and a tally of remaining/completed charts by reviewer. Validate full compliance and exclusion reports from external reviewers. 
  • Comprehensive NCQA-specific reporting

    • Receive up-to-the-minute results for HEDIS measures and reporting with in-line rate calculations and live reports. Benefit from the full suite of NCQA HEDIS measures, which are updated annually.
    • Manage provider group, physician, and plan performance. Used with Risk Manager, Compliance Reporter provides graphical reports of overall measure performance, quality results trending, and plan/product line performance.
    • Calculate financial rewards for quality and pay-for-performance metrics. When paired with Risk Manager, Compliance Reporter supports full quality management
      Lifecycle, providing robust reporting and measurement.

Our outcomes

View all insights


Need support for
this solution?

Explore related solutions

Join Community discussions

Find and share knowledge, exchange ideas, and collaborate with peers and Change Healthcare experts to drive your solutions to success.

Let’s start a conversation

We’re here to help you find out how this solution could benefit your organisation. Complete the quick form to the right, and someone will reach out to you soon.

Our experts will:

  • Discuss your individual use case and business needs
  • Explain our features, benefits, and services
  • Show how this solution can help achieve your goals

Want more information? Start here.

Thank You

We appreciate your interest in Change Healthcare. A member of our team will contact you to better understand your needs and discuss potential solutions.

Together, we are accelerating the journey toward improved lives and healthier communities.