Medvensys Quality360™ (NCQA-certified) allows payers and risk-bearing providers to measure quality using more than 150 clinical quality measures that span across HEDIS, eCQM and STARS. In addition, the platform deploys predictive analytics to pinpoint and prioritize quality/care gaps and assign most appropriate member and provider interventions.
Analyze all available administrative and clinical datasets to assess clinical quality compliance for every member along with care and quality gaps.
Using all HEDIS, eCQM and STAR measures, readily-assess provider compliance to care quality and identify improvement opportunities.
Provide the right care to all members along while improving overall quality of care, clinical outcomes and payment tied to quality scores.
Depending on member, disease and provider profiles close the care and quality gaps using the most appropriate interventions – Nurse Calls, Care or Disease Management, Case Management, Home Health or Provider Appointments.
Generate sustainable clinical and financial improvements by engaging providers with the right programs (education, gap-closure etc.) at the point-of-care.
Ensured high predictive accuracy by deploying hundreds of quality measures and related advanced analytics by applying various advanced statistical methods.
Integrate quality/care gaps and potential adverse events (ER utilization, readmissions, preference sensitive treatments etc.) and drive provider engagement to improve plan-level clinical and financial performance.
Significantly improve network efficiencies by leveraging top performers and supporting low-performing providers through varied provider collaboration strategies.
Proprietary analytical models enable decision makers to identify suitable value-based reimbursement strategies that improve clinical quality significantly.
Enhance provider performance by providing targeted recommendations via performance reports to drive continuous clinical and financial improvements.