Why Waiting Is Too Late for Digital HEDIS | Smile Digital Health

NCQA has formally announced the official retirement of traditional HEDIS reporting, paving the way for Digital HEDIS as the new standard by 2030. While this deadline may feel distant, the reality is that forward-looking organizations are already laying the groundwork to leverage Digital HEDIS. 

By initiating this transition as early as the 2026 Measurement Year, Payers can move from retrospective, manual processes to real-time, data-driven quality management. This proactive approach not only safeguards Star Ratings and maximizes reimbursements, but also positions early adopters as market leaders in a value-based care environment where agility, accuracy, and speed matter most.

The Case for Early Adoption

By 2030, NCQA requires all HEDIS submissions to be fully digital. Starting early creates tangible, compounding advantages that late adopters (those who wait until after 2027 to start) won’t be able to match:

• A Unified Data Ecosystem: One fully integrated FHIR® and CQL platform that ingests clinical data, evaluates digital measures and submits results.

• A Head-start on Quality Improvement: The ability to pilot digital measures, run the requisite year of parallel testing, refine internal processes, and lift HEDIS scores and STAR Ratings continuously.

• Strategic Insights: Decision-ready data through standards-based architecture (FHIR + CQL) for faster, smarter leadership decisions

• Enhanced Patient Care: Proactive gap alerts drive better outcomes in real-time, elevating both clinical performance and member satisfaction.

• Streamlined Governance: Centralizing compliance, audit trails, and reporting on one platform, reducing risk while simplifying oversight
• Accelerated ROI: Realizing cost savings and reimbursement gains sooner. HEDIS performance drives NCQA scores, Star Ratings, and bonus incentives, turning digital adoption into a measurable competitive advantage.
  
  

Digital Transformation Rewards Vision, Not Hindsight

Early adoption is not just about meeting NCQA requirements, it’s about positioning your organization at the forefront of Intelligent and modernized quality management. The difference between waiting until 2030 and acting today could mean years of missed opportunities in revenue growth, care improvements, and operational efficiency.
The following diagram illustrates how the shift from traditional HEDIS to Digital HEDIS creates these competitive advantages, and why starting sooner accelerates impact.

What To Do Next

Choose a comprehensive market-ready solution. Smile Digital Health’s dQM Measures for HEDIS is a single unified FHIR and CQL based, NCQA-aligned solution.