Valleywise Health achieved enhanced population health management and data-driven decision-making by deploying the Epic HEDIS module. Discover how they operationalized patient payer rosters, monitored performance with a comprehensive HEDIS scorecard, and implemented two value-based care program modules for improved healthcare outcomes.

Valleywise Health needed a partner with data-based analytics and governance expertise, as well as specific and deep Epic EHR knowledge to install and operationalize the HEDIS module. Tegria brought the leadership, technical skills, and experience we needed to manage the implementation from start to finish.

Kelly Summers, CHCIO, CDH, Senior VP, Chief Information Officer
Background and Challenge 

Despite limited budget and staffing resources, Valleywise needed deep subject matter expertise to help implement the Epic HEDIS (Healthcare Effectiveness Data Information Set) module that would enable them to use the same metrics as their payers and speak their “language.”  

HEDIS is a value-based performance management tool used by more than 90% of health plans in the United States to assess performance across key areas of care and outcomes. Certified HEDIS measures are calculated by combining clinical data from the EHR with claims information from payers. Implementing the HEDIS module would enable Valleywise’s data program to increase the speed and accuracy of key insights and help meet the immediate and long-term data needs of their community safety net healthcare system.  


Tegria experts conducted executive interviews and spent hours with the Valleywise data team to develop the strategy for how the HEDIS implementation would serve the larger vision of Valleywise’s data program. “We worked together on a presentation that led to a formal data program charter, and ultimately the successful recruitment of our first Data Program Manager, while more efficiently using all the elements in our Epic Cogito toolkit,” said Valleywise Health VP and Chief Medical Information Officer Anthony Dunnigan, M.D., MBI, FAMIA.   

Simultaneously, the Tegria team drove the HEDIS implementation by serving as liaison to two payers and overseeing the automated delivery of payer data files required for the project. They also worked with Epic and key project stakeholders to resolve issues with patient rosters, including how to operationalize the rosters with health information management for ongoing support.   

  • Successfully deployed two value-based care program modules 
  • Improved population health management by implementing and operationalizing patient payer rosters 
  • Deployed a comprehensive, actionable HEDIS scorecard to monitor program execution, including measures performance and care cap tracking 
  • Enabled data-driven decision-making around care processes and quality improvement

What if your system could speak “payer?” Let's talk about HEDIS.

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