DavisJones Consulting Group connects HEDIS hybrid operations, year-round data collection, supplemental data engineering, FHIR® data transformation, executive analytics, and rating strategy into one disciplined performance model — for health plans across Medicare/Duals, Medicaid, Exchange, and Commercial/ICHRA, and for the provider organizations, HIEs, and digital health vendors that supply their clinical data.
DavisJones delivers end-to-end measure data collection — project management, retrieval (ROI vendor coordination, onsite collection, EMR retrieval), abstraction, overread, and MRRV — available for both HEDIS hybrid season AND year-round operations. Around that core delivery, we provide supplemental data engineering, FHIR® data transformation and integration, executive analytics, ratings strategy, ECDS readiness, and custom QI and accreditation training — for health plans and for the provider organizations, health systems, HIEs, and digital health vendors that produce the clinical data behind every quality measure.
Full hybrid season measure data collection — from project kickoff to closeout. We deliver every step of the chain so plans don't have to stitch together multiple vendors. Tool-agnostic: we work inside Inovalon QSI-XL, Reveleer, Cotiviti, Episource, or another platform.
The same end-to-end data collection stack — operated continuously, twelve months a year — plus the supplemental data engineering and governance work that drives audit success. For plans that need both chart-level operations AND visibility into their full supplemental data pipeline.
Strategic advisory and measure-specific improvement for plans serious about moving rates. Deep expertise across Medicaid Adult and Child Core Sets, Medicare Stars, Marketplace QRS, and NCQA Health Plan Ratings — with practical, intervention-level recommendations.
The industry is moving from hybrid sampling to fully digital quality measurement by 2030 — and that transition is fundamentally a data integration and data standardization challenge. We help organizations design their clinical data architecture, transform non-standard source data into FHIR®-conformant formats, and build the integrated infrastructure required to thrive in the digital measurement era. This work is not limited to health plans — provider groups, health systems, HIEs, data aggregators, and digital health vendors face the same standardization requirements.
Most quality teams inherit their knowledge from whoever held the role last. We build structured, role-specific training programs that turn quality measurement from tribal knowledge into a documented, teachable capability — designed around your measure set, your platforms, your populations, and your accreditation timeline.
Beyond our four core service lines, we bring focused expertise in the specialized capabilities health plans need to move ratings, govern their data, defend audits, and translate complex data into executive decisions.
Measure-level strategy to move ratings — closing the gap between reported scores and 4.0+ performance across HEDIS, Stars, QRS, and HPRS programs.
Intake QA frameworks, file receipt monitoring, cadence compliance, rejection management, dedup/windowing strategy, LOB crosswalks, and code-set hygiene across the full supplemental data pipeline.
Vendor performance analysis, root-cause diagnostics on rejection patterns, supplemental data audits, and governance maturity assessments — turning data chaos into a remediation roadmap.
KPI frameworks, market-level performance scorecards, SLA monitoring, and Power BI / Power Pivot models that translate operational data into leadership-grade decision support.
Specialized chart retrieval coordination across Datavant, MRO, Sharecare, and Verisma — submission, tracking, file hygiene, platform upload, and vendor invoice reconciliation.
Translating quality data into targeted operational decisions — PDC trending, missing A1c analysis, duals/non-duals, behavioral health coding, and intervention targeting.
Monthly intervention ROI analysis, performance leakage identification, outreach channel and timing optimization, and measure-specific intervention strategy.
Schema and SLA enforcement, partner playbooks, RCA closure tracking, and vendor scorecards — strengthening the data partnerships that underpin reliable quality reporting.
Weekly check-ins, RAG status reporting, retrieval burndown, top-provider escalations, rate-gap forecasting, and audit-ready documentation.
Supplemental data source strategy, vendor evaluation across aggregators (Datavant, Quest, LabCorp, Tessellate, MIHIN), data acquisition roadmaps, and integration governance — connecting the right data sources to the right downstream platforms.
Converting HL7® v2, CCDA, flat-file, and proprietary EHR extracts into FHIR® US Core-aligned resources — with terminology mapping (LOINC, SNOMED CT, RxNorm), conformance testing, and upstream data quality evaluation. DavisJones licenses NCQA’s HEDIS® Data Quality Specifications and uses them to evaluate clinical data quality across completeness, conformance, and plausibility dimensions.
Custom QI and accreditation training programs — role-based learning tracks, facilitator guides, workbooks, competency assessments, and provider-facing coding and documentation education, built around your measure set and your accreditation timeline.
Medicare Advantage and Dual Special Needs Plan operations — Stars rating strategy, CMS measure preparation, and quality programs serving dual-eligible populations.
State Medicaid Adult and Child Core Sets, managed care quality reporting, and multi-state program experience.
Marketplace QRS programs, Qualified Health Plan quality reporting, and CMS Marketplace measure preparation.
Commercial group health and Individual Coverage HRA quality operations — emerging program support for employer-sponsored and ICHRA-funded plan structures.
Quality measurement runs on clinical data that health plans do not create. Our data integration, FHIR® transformation, data quality, and training work serves any organization that produces, moves, or consumes clinical data for quality reporting — not just payers.
Most consulting firms tell health plans what to do. We do it with them. Every engagement is staffed by senior people who have actually run hybrid seasons, managed retrieval vendors, abstracted charts, and survived an NCQA audit — and we mentor your team alongside our work, so capability stays with you after we're gone.
We don't hand you a slide deck and leave. We sit inside your project plan, run your stand-ups, write your status reports, and mentor your HEDIS, analytics, and PM teams so your in-house capability grows alongside ours.
We work within the platforms you already pay for. Inovalon, Reveleer, Cotiviti, Episource — we know the workflows and the limitations of each, and we don't try to sell you replacement software.
Hybrid season is one chapter of a longer story. We help plans build supplemental data operations and digital measurement capabilities that compound across measurement years.
NCQA is moving HEDIS toward fully digital, electronic clinical data system (ECDS) reporting. By 2030, the hybrid sampling methodology that has defined chart abstraction for two decades will largely be gone.
This is not a small operational change. The skill set that wins on hybrid season — chart chase, retrieval coordination, abstraction overread — has to be redirected toward year-round supplemental data operations, primary source verification of non-standard data, and rigorous audit-trail documentation.
DavisJones is positioned for both. We deliver hybrid season excellence today and build the year-round, audit-ready supplemental data operations that will define quality measurement tomorrow.
A monthly read for quality leaders — on where measurement is going, what is changing in the specifications, and what to do about it before it becomes a rate problem. Written by practitioners, not marketers.
Every rate you report is the output of a supply chain — and that supply chain is the part of the operation that rarely has a single owner. Inside: the eleven data supply chains behind every measure, the MY 2026 ECDS transitions already in progress, the QRS hybrid transition clock, NCQA’s shift toward continuous data quality monitoring, and how to design data sets people can actually act on.
Read the issue →The CY 2027 final rule made the largest changes to the Star Ratings measure set in years. What the removals, the retained reward factor, and the new depression screening measure mean for 2027–2029.
Get notified →Get The Measure Ahead in your inbox. One email a month. No sales sequence, no drip campaign — just the analysis.
Subscribe →A representative example from our portfolio of 100+ completed hybrid projects.
Multi-addendum engagement spanning hybrid season project management, retrieval vendor coordination, supplemental data quality analysis, and ongoing enterprise quality management consulting. Scope covers seven distinct plan entities across Medicaid, Marketplace Exchange, and Duals populations — in multiple states.
DavisJones Consulting Group is a woman-owned healthcare quality consulting firm based in South Carolina, established in 2017. We help health plans excel across the full quality stack — HEDIS®, Stars, QRS, and HPRS — combining hands-on data collection operations with supplemental data engineering, executive analytics, and rating strategy. Through our data integration and FHIR® transformation work, we also serve the provider organizations, health systems, HIEs, and digital health vendors that generate the clinical data quality measurement depends on — and we build the training programs that make quality capability stick.
Our principals have spent careers inside health plans and quality vendors, running hybrid seasons, managing supplemental data, navigating NCQA audits, and translating regulatory change into operational reality. We bring that experience directly to the engagements we lead — across 100 completed hybrid projects, with a 100% MRRV pass rate every year.
We are deliberately small, intentionally specialized, and uninterested in selling work outside our expertise. When you hire DavisJones, you get senior people doing senior work — and mentoring your team while they do it.
Thirty minutes, no obligation — bring your measure set, your data problem, or your training gap and we will tell you honestly whether we are the right fit.
Whether you need hybrid season capacity, ongoing supplemental data operations, ratings strategy, a FHIR® data transformation partner, or a custom QI training program, we'd like to hear about your program.