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Solution suite

Quality Solutions

Improve quality with a comprehensive, innovative approach to manage HEDIS® performance.

The quality measurement engine has both retrospective and prospective services.

Enhance clinical quality performance

Rising medical costs, affordability pressure, ever-changing reimbursement models, increased regulatory requirements and public reporting cause health plans to increase focus on quality metrics.

Multiple vendors can be costly. By enhancing clinical quality performance, health plans can improve health outcomes and reduce the cost of care.

Leverage a powerful reporting solution

Our comprehensive quality measures reporting solution helps you:

  • Minimize data transfer
  • Expedite the audit process
  • Streamline all measures activity to maximize efficiency and help ensure successful NCQA, CMS and state submissions

We’re committed to help you maximize data and processes to increase accuracy and completeness of HEDIS and other quality program scores and performance: 

  • Cloud-based HEDIS reporting system
  • Medical record review support
  • Audit management
  • Performance assessment

A proactive approach to prospective quality measurement

Drive quality programs in the measurement year by identifying gaps in care while reducing retrieval costs for the upcoming season. An integrated comprehensive quality and risk adjustment process may reduce provider abrasion.

  • Supplemental data collection and review
  • Quality analytics as a service

Retrospective services bring your quality efforts full circle

We help health plans maximize data and processes to increase accuracy and completeness of HEDIS and other quality program scores and performance. By enhancing clinical quality performance, health plans can improve health outcomes and reduce the cost of care.

  • Measurement reporting and submissions
  • Maximize HEDIS collection and streamline medical record review processes

Quality services

Medical Record Retrieval

Maximize HEDIS collection and streamline medical review processes.

Learn more

Related healthcare insights

White paper

Risk adjustment star ratings success

Discover 5 strategies that will help your health plan be prepared to factor risk adjustment data into Star Ratings.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).