Roji Health Intelligence Earns 19th CMS Certification Amidst Rising Stakes in Value-Based Care

CHICAGO, IL – January 22, 2026 – Roji Health Intelligence, a healthcare technology firm, announced it has been re-certified as a Centers for Medicare & Medicaid Services (CMS) Qualified Registry for 2026. This marks the company's 19th consecutive year earning the designation, placing it among an elite group that has been certified since the program's inception in 2008. While the annual certification may seem like a routine update, it arrives at a critical juncture for the U.S. healthcare system, where the pressures of value-based care, complex reporting requirements, and direct financial risk are converging on providers like never before.

For healthcare organizations, this certification underscores the growing necessity of partnering with proven data experts to navigate an increasingly treacherous regulatory and financial landscape. The re-certification validates that Roji's ONC-certified Clinical Data Registry Platform meets the rigorous federal standards for data integrity, security, and interoperability required to report quality and cost measures to CMS.

The Mounting Pressure of Value-Based Care

The landscape for Medicare reimbursement is in the midst of a seismic shift, moving decisively away from fee-for-service models and toward systems that pay for value and outcomes. This transition is spearheaded by two key CMS initiatives: MIPS Value Pathways (MVPs) and an expansion of Alternative Payment Models (APMs). Both place a heavy burden on providers to not only deliver high-quality care but also to meticulously document and report it, all while managing costs.

MVPs represent an evolution of the Merit-based Incentive Payment System (MIPS), aiming to create more cohesive and specialty-focused reporting pathways. However, this transition introduces new complexities. For the 2026 performance period, CMS requires multispecialty groups to report MVPs at the subgroup or individual level, a significant change that demands more granular data collection and management. The administrative overhead to simply keep pace with these evolving rules, which for 2026 included adding five new quality measures and substantively changing 30 others, can be overwhelming for practices of all sizes.

Simultaneously, the expansion of APMs pushes providers further into arrangements that involve direct financial risk. In these models, providers who deliver efficient, high-quality care can share in the savings, but those whose costs exceed targets may be forced to pay back a portion to CMS. This two-sided risk model turns quality reporting from a compliance exercise into a high-stakes financial imperative.

"We are thrilled to be recognized by CMS as an organization with the proven technology and infrastructure to be a trusted partner in the healthcare ecosystem,” said Theresa Hush, CEO at Roji Health Intelligence. “Earning this certification reflects our commitment to creating a healthcare system that demonstrably delivers better care at a lower cost.”

A Beacon of Stability: The Role of Qualified Registries

In this turbulent environment, CMS Qualified Registries serve as essential data intermediaries. These CMS-approved entities collect clinical data from providers and submit it to the government on their behalf, significantly reducing the administrative burden. More importantly, they provide a layer of expertise and validation, ensuring the data is accurate, complete, and formatted to meet CMS’s exacting standards.

Continuous certification, such as Roji's 19-year streak, signals more than just compliance; it signifies resilience, adaptability, and deep institutional knowledge. Over nearly two decades, the firm has helped healthcare organizations navigate a series of major regulatory shifts, from the original Physician Quality Reporting Initiative (PQRI) to the current Quality Payment Program (QPP). This longevity provides a measure of stability and trust for providers who cannot afford to gamble on unproven partners.

Qualified Registries are now required to support the new MVPs applicable to their participants, a mandate that further separates established players from newer entrants. By demonstrating the capability to handle these complex new pathways, firms like Roji position themselves not just as data conduits, but as strategic advisors helping clients stay ahead of the regulatory curve.

Beyond Compliance: Mitigating Financial Risk with Data Intelligence

The most profound shift in the CMS payment structure is the direct link between performance data and a provider's bottom line. Under MIPS, a provider's final score—based on performance in Quality, Cost, Improvement Activities, and Promoting Interoperability—results in a positive, neutral, or negative adjustment to their Medicare Part B payments. With the performance threshold set at 75 points, the risk of financial penalties for underperformance is substantial.

This is where the function of an advanced clinical data registry extends far beyond simple reporting. Platforms like Roji's are designed to help providers actively manage and improve the very metrics that determine their financial fate. By aggregating and analyzing data from disparate sources like electronic health records and claims, the technology can identify key cost drivers, highlight variations in care, and benchmark performance against regional and national peers.

This analytical power is crucial for success in risk-based APMs. To avoid financial losses, providers must have a clear, data-driven understanding of their cost performance across entire episodes of care. Roji's platform includes services specifically designed to support these financial risk models, enabling organizations to identify and address quality issues and cost drivers before they negatively impact reimbursement. By turning raw data into actionable intelligence, these tools empower providers to make informed clinical and operational decisions that improve both patient outcomes and financial stability, effectively turning a regulatory burden into a strategic opportunity.