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Strategy Guide

Trends for health plan quality performance

An outlook report on how health plans can stay ahead of the curve and prepare for key trends likely to impact their quality programs in 2025 and beyond.

As quality program requirements continue to change for health plans, so must your approach. With regular adjustments and updates from organizations like the Centers for Medicare & Medicaid Services (CMS) and the National Committee for Quality Assurance (NCQA), health plans must continuously re-evaluate their technology, digital capabilities and member programs. Learn how your health plan can stay ahead of the curve by:

  • Adopting a digital-forward approach, including improved accuracy, efficiency, member engagement and timeliness.
  • Shifting strategies to include prospective quality management allowing for a year-round approach.
  • Balancing the emphasis on HEI and SDOH measures, while maintaining member experience programs.

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