The National Committee for Quality Assurance (NCQA) has struck a multi-year strategic partnership with Komodo Health to change how healthcare quality measures are developed and tested. Under the agreement, NCQA researchers will use Komodo’s Healthcare Map—a longitudinal dataset of more than 330 million de-identified patient journeys—and Komodo’s AI platform, Marmot, to analyze care across insurance types, care settings and patient populations from a single source.
NCQA remains the sole authority responsible for creating HEDIS (Healthcare Effectiveness Data and Information Set) measures, but the new data and analytic access is intended to make measure evaluation faster and more aligned with real-world patterns of care.
Komodo’s Healthcare Map aggregates claims, lab and other de-identified data into a single longitudinal view covering Medicare, Medicaid and commercial populations. According to Komodo, the Map is continuously refined to increase its breadth, depth and longitudinal coverage. NCQA will also have access to Marmot, Komodo’s AI-powered healthcare intelligence platform, which is designed to help researchers explore complex questions and produce transparent, reproducible outputs.
Tricia Elliott, NCQA’s vice president of quality implementation, told Fierce Healthcare that using the Healthcare Map "has greatly streamlined" testing workflows. Because the Map includes multiple insurance populations in one dataset, NCQA researchers can evaluate measures across insurance types without running separate analyses for each population.
Komodo supported NCQA’s development and testing of a new measure—Follow-Up After Positive Colorectal Cancer Non-Invasive Screening Test, referred to as COF-E—that is slated for implementation in Measurement Year 2027. For that project, NCQA used lab data and claims information to assess follow-up rates after a positive stool-based screening test.
NCQA reported that testing time was cut nearly in half when using Komodo’s resources, taking about a month to evaluate Medicare Advantage, Medicaid and commercial populations. The shortened testing timeline demonstrates the operational efficiencies NCQA expects to gain from the partnership.
Quality measures guide how healthcare organizations assess performance and identify opportunities to improve care. NCQA leaders said a comprehensive, current view of care across patient populations is critical for creating measures that reflect what is actually happening in practice.
Komodo co-founder and co-CEO Web Sun told Fierce Healthcare that the Healthcare Map and Marmot were engineered to provide that kind of comprehensive view. NCQA’s stated objective is to leverage Komodo’s capabilities broadly to support ongoing measure innovation, maintenance and evaluation, while continuing to tailor specific testing approaches to individual project needs.
Historically, developing and testing new quality measures required pulling together disparate datasets and conducting field testing with individual payers or partners. That process often required separate analyses for each population studied and could take two to three months for testing alone.
By contrast, NCQA said the single-source approach with Komodo reduced duplication of effort and allowed more rapid cross-population comparisons. This single-dataset workflow aims to accelerate evaluation timelines and deliver measure testing that is more consistently comparable across insurance types.
The source article notes that the Healthcare Map is composed of de-identified patient journeys and that Komodo continuously refines and expands the dataset. Specific technical details about de-identification processes, data sources beyond lab and claims, or privacy safeguards were not reported in the source.
NCQA retains responsibility for the design and validation decisions for HEDIS measures; Komodo’s role is to provide data and analytic tooling to support those activities.
NCQA indicated it expects Komodo to serve as a key platform supporting HEDIS measure testing activities across NCQA’s portfolio. The organization plans to use the capability broadly for measure innovation, maintenance and evaluation, while allowing individual project needs to guide specific testing approaches.
Komodo said it is focused not only on expanding its dataset but also on helping organizations turn that data into actionable intelligence for decision-making. The source did not provide a detailed roadmap for which HEDIS measures will be next or timelines beyond the Measurement Year 2027 COF-E implementation.
The NCQA–Komodo partnership links a national quality oversight body with an AI-enabled, longitudinal healthcare dataset and analytics platform. NCQA aims to use these resources to shorten testing timelines, evaluate measures across multiple insurance populations from a single source, and align future HEDIS measures with patterns observed in real-world care. Specific future measures and detailed technical or privacy controls were not detailed in the report.
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