As NCQA’s 2030 digital HEDIS deadline approaches and CMS regulations intensify, health plans are under increasing pressure to deliver faster, better care and at lower cost. Many organizations have responded by layering multiple vendor-systems that add complexity to already burdensome processes, just to meet regulations. But these fragmented approaches create inconsistent data, disconnected insights, and inefficiencies that block true transformation.

Most Payers assume their data is “good enough”; until assessments or audits reveal costly inconsistencies and missed opportunities. 

The Smile Data Quality Playbook introduces a new lens for US Payers, and maps out how strategically investing in digital quality transformation today accelerates modernization, mitigates risk, and lays the groundwork for a sustainable, data-driven future. It offers Payers a clear framework for turning today’s fragmented data into standardized, computable, and actionable knowledge that fuels smarter decisions, higher Star Ratings, and operational efficiency across the enterprise.