Qualit8 provides the advanced analytics that are needed to monitor, measure, and report on each quality metric, along with risk adjustment programs, all under one tool.
Nashville, TN (PRWEB) March 07, 2017
HEDIS®-based quality metrics are progressively driving the accountability and profitability of government programs with payments, penalties, and bonuses that are “graded on a curve” relative to the competition. A myriad of Quality Improvement initiatives exist, all aimed at improving one’s scores, but far too numerous and costly to blindly pursue. To successfully navigate this maze, today’s health plans need to employ a data-driven triad of gap identification, strategic intervention, and dynamic recalibration. Qualit8 provides the “command center” from which to orchestrate your Quality Management endeavors, using a series of inter-related analytic dashboard suites.
Qualit8 integrates efforts to close Quality gaps with those aimed at Documentation and Coding, to produce a coordinated road map that is more efficient for the plan, less disruptive to providers, and more respectful of the members. Qualit8 helps to optimally deploy your finite resources in order to maximize financial impact and document care quality by:
- Assessing the likelihood of closing each gap at the individual provider- and member-level,
- Prioritizing the revenue impact of addressing each quality metric, and
- Grading providers and medical groups on both clinical performance and coding efficacy.
Key Features making Qualit8 the most strategic, dynamic, and coordinated solution for closing quality gaps and improving quality scores:
- Predictive models to identify all members who belong in the denominator of each metric, including false negatives not yet recognized by care management and those tied to chronic conditions not currently coded and/or at risk for disease progression
- Dynamic Intervention Planning that incorporates member and provider behavior
- Advanced Analytics for monitoring, measuring, and reporting on each quality metric
- Dashboards that enable QM professionals to proactively identify trends in measure performance and drill down to the member level
“With the rapid growth of financial incentives and penalties linked to risk- and quality-based payments, it is critical for plans and providers to align program efforts. Qualit8 provides the advanced analytics that are needed to monitor, measure, and report on each quality metric, along with risk adjustment programs, all under one tool. Combining your risk and quality efforts can help reduce provider abrasion, increase the quality of care for your patients, and increase revenue from risk and quality payments. If you are not already combining efforts in 2017, it is critical that you implement a solution that supports program integration,” stated Kari Hadley, Senior Director of Medicaid and Quality Products at Pulse8.
Pulse8 is the only Healthcare Analytics and Technology Company delivering complete visibility into the efficacy of Risk Adjustment and Quality Management programs. We enable health plans and at-risk providers to achieve the greatest financial impact in the ACA Commercial, Medicare Advantage, and Medicaid markets. By combining advanced analytic methodologies with extensive health plan experience, Pulse8 has developed a suite of uniquely pragmatic solutions that are revolutionizing risk adjustment and quality. Pulse8’s flexible business intelligence tools offer real-time visibility into member and provider activities so our clients can apply the most cost-effective and appropriate interventions for closing gaps in documentation, coding, and quality. For more company information, please contact Scott Filiault at (732) 570-9095, visit us at http://www.Pulse8.com, or follow us on Twitter @Pulse8News.