NCQA is handing artificial intelligence a role in one of healthcare’s most influential scorecards. The nonprofit behind the HEDIS quality measures, used across commercial, Medicaid and Medicare plans, has signed a multi-year collaboration with Komodo Health to rebuild how those measures are created and validated.
Komodo contributes two assets. The Healthcare Map holds more than 330 million de-identified patient journeys, covering different insurance types and care settings in one longitudinal source, replacing the fragmented datasets that historically slowed measure development. Marmot, the company’s healthcare-native AI analytics platform, allows NCQA researchers to probe complex questions quickly while keeping analyses transparent and reproducible.
COF-E is the first measure to emerge, a HEDIS addition tracking whether a positive non-invasive colorectal screen is followed by a timely colonoscopy. NCQA said the measure moved through development and testing faster than conventional routes.
Tricia Elliott, NCQA’s vice president of quality implementation, described the goal as a more dynamic approach to measurement that keeps pace with clinical evidence without weakening rigor. Komodo executives frame the deal as evidence that real-world data and healthcare-specific AI can shorten the distance between new science and the metrics insurers and providers actually use.
For payers and health systems, faster measure updates mean quality benchmarks can reflect current care delivery instead of lagging years behind. The arrangement also puts Komodo inside the most widely used performance improvement tool in American healthcare, a meaningful validation for its AI platform.
