Clinical Quality

Enabling End-to-End Quality Measurement and Improvement

QUALITY MEASUREMENT AND IMPROVEMENT SOLUTIONS

Better Quality Compliance Leading to Improved Clinical Outcomes

Through our outcomes-oriented quality solutions, we serve plans operating in MA, HIX and Medicaid markets to improve quality compliance in a ROI-sensitive manner. The analytics approach includes applying member’s behavioral attributes and socio-economic factors, in addition to standard demographic and clinical factors, to design interventions that yield significant gap closure rates.

  • HEDIS and STARS Measurement and ReportingHEDIS and STARS Measurement and Reporting
  • Medical Record RetrievalMedical Record Retrieval
  • HEDIS-Hybrid AbstractionHEDIS-Hybrid Abstraction
  • Gaps-in-Care ReportingGaps-in-Care Reporting
  • Predictive AnalyticsPredictive Analytics
  • Gap Closure OperationsGap Closure Operations
Quality 360Value based Contracting
QUALITY MEASUREMENT AND IMPROVEMENT
QUALITY MEASUREMENT AND IMPROVEMENTQUALITY MEASUREMENT AND IMPROVEMENT

There has been an increase in focus on Quality Compliance for health plans due to the launch of several quality bonus programs. While increase in compliance to quality and care guidelines is a certain area of focus for plans, it is becoming a key competitive factor as quality ratings start to drive enrollments. As part of our Quality programs, Medvensys integrates superior care coordination models to improve care for members and generate high ROI for health plans. All the analytic insights are translated to identify provider practice patterns and hence tailor alternate payment models that drive long-term efficiencies. Our Quality solutions are EMR ready – with our proprietary EMR-Connectors – to automatically extract the targeted DOS/charts from EMR systems to identify care and quality gaps on a near real-time basis.

Client Benefits

  • Improved Quality Compliance

    Improved Quality Compliance

  • Increased Member Satisfaction

    Increased Member Satisfaction

  • Cost Effective Hybrid Operations

    Cost Effective Hybrid Operations

  • Improved Plan Performance

    Improved Plan Performance

  • Improved Provider Performance

    Improved Provider Performance

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