SOURCE: MEDecision, Inc.

MEDecision, Inc.

August 25, 2011 09:15 ET

MEDecision Achieves NCQA HEDIS® Re-Certification

Clinical Intelligence Rules Identify Treatment Opportunities for Improved Health Outcomes

WAYNE, PA--(Marketwire - Aug 25, 2011) - MEDecision, Inc., the leading provider of collaborative health management solutions, has again earned the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) Software Certification for its preventive health and wellness Clinical Intelligence Rules that help healthcare organizations proactively identify opportunities to improve member health through interventions based on evidence-based medicine.

According to the Institute of Medicine, the healthcare industry wastes $55 billion(1) each year on missed opportunities for healthcare interventions. Today's healthcare organizations require sophisticated care management applications to reduce waste and focus on targeted, proactive member outreach. MEDecision's Nexalign® Clinical Intelligence Rules analyze data from multiple sources -- claims, pharmacies, labs and electronic health records -- and identify target populations at risk, and individual health plan members, who would benefit from interventions to improve health outcomes, cost and quality.

Once the Clinical Intelligence Rules have effectively identified members for treatment opportunities, the software directs these at-risk members to health plan care managers or other healthcare professionals for case and disease management -- targeting chronic illnesses such as asthma and diabetes. Health plans are able to see and track results across a population of members regarding issues like compliance to treatment plans or reductions in hospital readmissions, driving the value of their care management strategies to their customers.

"NCQA HEDIS re-certification of MEDecision's Clinical Intelligence Rules software demonstrates the Company's commitment to meeting the highest clinical standards in the industry," Deborah M. Gage, president and chief executive officer, MEDecision, said. "Our goal is to provide health plans with software solutions that help them meet their own standards, identify treatment opportunities and engage members with personalized care plans to foster better preventive care -- improving member health."

NCQA Software Certification signifies that the populations identified for care opportunities by MEDecision Clinical Intelligence Rules are aligned with the widely adopted NCQA quality measures. NCQA validates software by generating unique sets of test data that solutions providers process using their software. The output is compared to the expected results to determine if the software computes results according to the specifications.

"Health plans must meet rigorous standards of review and report on key performance areas to earn NCQA accreditation. Solutions providers like MEDecision who achieve the NCQA seal of approval confirm their commitment to quality to their customers," said Mary Braman, NCQA's director of licensure and certification. "NCQA standards promote the adoption of strategies that we believe will improve care, enhance service and reduce costs, such as paying providers based on performance."

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(1) Yong, Pierre L. and LeighAnne Olsen. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Washington, D.C.: The Institute of Medicine of the National Academies, 2010.

About NCQA

NCQA is a private, non-profit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers.

About MEDecision

MEDecision's contribution to the healthcare industry is a powerful platform that delivers meaningful data to inform the most important healthcare transaction: patient care. We start with a philosophy that patients, providers and payers are all driving towards better health outcomes and that this common interest dictates the need for collaborative working environments. Then, we apply more than 22 years of experience, $85+ million in research and development and the strongest clinical knowledge to deliver the MEDecision collaborative health management platform, which includes Nexalign®, a health decision support service that applies analytics to information gathered from multiple sources to foster better business and clinical decisions on a patient's behalf, Alineo®, a health management platform for delivering outcome-driven case, disease, utilization and behavioral health management, and InFrame™, a set of tools to facilitate the health and performance management processes for physicians and accountable care organizations. For more information, visit

MEDecision is a trademark of MEDecision, Inc. The MEDecision logo and product names are also trademarks or registered trademarks of MEDecision, Inc. Other product and brand names are trademarks of their respective owners.

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).

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