Data collection, simplified
A major shift is underway in quality performance. NCQA is transitioning away from the hybrid model currently used for HEDIS®* reporting and CMS is moving away from retrospective HEDIS chase programs to focus on prospective actions and quality of care delivery.
As we move toward targeting the Interactive Data Submission System (IDSS) population, many health plans need help implementing a prospective, year-round, digital-first strategy that is both scalable and cost-effective.
Optum offers quality data collection and review solutions to prepare health plans for the future of quality.
The future of quality data collection and review
Year-round chart retrieval
Prepare for upcoming changes in quality data collection and reduce dependency on hybrid collection with year-round retrieval and abstraction services for medical record review.
Prospective focus
Align with NCQA’s roadmap by adopting prospective-forward initiatives now. Prospective strategies can help increase supplemental data collection, deliver better member outcomes and improve provider scorecards.
Audit support
Receive audit support for medical record review verification (MRRV) and primary source verification (PSV) for charts and digital data.
Key benefits
Transform quality data collection and review with a tech-driven, prospective strategy.
Digital-forward approach
We use artificial intelligence and machine learning auto abstraction models to identify charts with valuable clinical quality information without the need for time-consuming manual abstraction on existing or newly retrieved charts.
Continuity of care documents
Retrieve continuity of care documents (CCD) from our network of direct electronic medical record (EMR) connections and convert the CCD into a supplemental source to enable care gap closure.
National provider network
Optum maintains relationships with providers across the country, allowing us to retrieve charts and perform clinical abstraction year-round using our AI-powered platform.
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Product information and resources
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Sell sheet
Quality data collection and review
Prepare for the transition away from the hybrid reporting model with a prospective data collection and review strategy powered by AI and machine learning technology.
Complementary solutions
Retrieval services
Prospective Solutions
*HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).