The End of Traditional HEDIS® Is Coming: What Payers Need to Know

For decades, HEDIS^® reporting has relied on a fragmented and manual process. NCQA would publish narrative specifications for each measure, and vendors have historically interpreted and implemented those guidelines on their own, leading to proprietary systems, redundant coding efforts, and costly certification cycles to validate accuracy.

But all that is changing.

NCQA’s Push Toward Digital Quality Measurement

To meet the growing demands of value-based care and enable real-time, data-driven insights, NCQA has launched its Digital Content Services (DCS) program, marking the transition to digital HEDIS. Rather than interpreting written guidance, vendors and payers can now directly access and utilize official HEDIS measures as machine-readable artifacts in FHIR^® and CQL.

Importantly, this shift, though not yet mandated, is imminent. NCQA has announced a target of 2030 to fully retire traditional HEDIS, ending certification for proprietary interpretations and standardizing the path forward with digital-first content.

What This Means for Payers

Payers relying on traditional, manual HEDIS processes will face:

• Rising administrative costs
• Delayed quality insights
• Inability to meet real‑time reporting demands, and limited scalability
• Increased risk of provider and member dissatisfaction
• Increased competition for CMS Star Rating’s bonus payments

Moving to digital HEDIS is a strategic modernization effort, beyond the check-the-box compliance. Early adopters gain agility, accuracy, interoperability, and market leadership in tomorrow’s data-driven healthcare landscape.