Healthcare Quality Measurement Gets an AI Overhaul as NCQA Taps Komodo to Slash Development Time in Half

The National Committee for Quality Assurance (NCQA), the authoritative body behind healthcare's most widely used quality measures, has struck a multi-year strategic partnership with Komodo Health that could fundamentally reshape how the industry evaluates care quality. The collaboration will deploy Komodo's AI-powered Healthcare Map platform and Marmot intelligence tool to develop and test future HEDIS measures—the quality benchmarks that health plans and providers across the country use to assess performance.

The partnership promises to cut measure development testing time nearly in half, from the traditional 2-3 months down to approximately one month per population, according to the companies. This acceleration comes from replacing fragmented, labor-intensive data collection with access to a single longitudinal database containing over 330 million de-identified patient journeys spanning Medicare, Medicaid, and commercial insurance populations.

Solving a Decades-Old Development Bottleneck

Historically, creating new HEDIS measures required NCQA to pull from disparate datasets and conduct separate field testing with individual payers for each population studied—a cumbersome process that slowed the organization's ability to respond to emerging care patterns and population health needs.

Komodo's Healthcare Map eliminates this fragmentation by providing a consistent data source across insurance types and care settings. The platform's Marmot AI tool delivers what the companies describe as transparent, reproducible analytical outputs, addressing a critical need for reliability in standards-setting work.

"This partnership allows us to leverage cutting-edge technology and comprehensive data to develop measures that truly reflect the complexities of modern healthcare delivery," said Tricia Elliott, VP of Quality Implementation at NCQA, in announcing the collaboration.

The first measure developed using the Komodo platform—Follow-Up After Positive Colorectal Cancer Non-Invasive Screening Test (COF-E)—is scheduled for implementation in Measurement Year 2027, providing an early test case for the new approach.

Implications for Quality Measurement's Future

For health plans and providers subject to HEDIS reporting, the partnership could yield quality measures that more accurately reflect real-world care patterns across diverse populations. Rather than relying on data collection methods that may lag clinical practice evolution, the AI-powered approach aims to identify care gaps and coordination issues more rapidly.

Web Sun, Co-founder and Co-CEO of Komodo Health, framed the collaboration as validation of large-scale patient journey mapping for regulatory purposes. "By partnering with NCQA, we're helping to ensure that quality measures keep pace with the evolving healthcare landscape and drive meaningful improvements in patient outcomes," Sun stated.

The partnership also signals broader acceptance of AI-powered real-world evidence platforms in healthcare policy and standards development—a domain traditionally dominated by claims data and manual chart review. For patients, faster measure development could translate to quicker identification and remediation of care gaps, particularly in critical areas like screening follow-up and care coordination.

The multi-year strategic nature of the partnership suggests NCQA views the collaboration as foundational rather than experimental. Komodo Health's selection positions the company as essential infrastructure for healthcare quality measurement, potentially raising competitive stakes for rival patient journey mapping platforms and cementing Komodo's role in shaping how healthcare quality is defined and measured for years to come.

Sources

1. NCQA to use Komodo data, AI tool to develop future HEDIS measures — Fierce Healthcare