Payer Solutions
Quality Management
As the industry focuses on quality, it’s important for payers to implement quality management programs that monitor and support quality care measures. Quality Management offers insights that enable you to understand performance, achieve compliance and ultimately improve quality care.
Improve quality measure performance
Improve plan performance
Increase efficiencies with scalable,
quality reporting
Drill down to claims for detailed insights
Let your data tell the story
Quality Management was designed to give you the data and insights you need to manage compliance while also improving quality across the healthcare ecosystem. Increase efficiencies with scalable, quality reporting as well as engage providers in year-round evidence gathering. Higher ratings mean improved rankings and a stronger plan reputation. See what our clients have achieved:
Time spent on quality reporting and submissions
Temp and third-party vendor costs
Faster insights for better outcomes
Quality Management gives you the data you need to run measures according to strict national standards and streamline your process in order to bring plan performance into greater focus throughout the year. You can report on quality measures and reduce the risk of a failed audit, all without the need for additional resources. Quality Management enables you to:
Improve health plan rankings
With quality measure analytics, you can report on all measures including NCQA HEDIS®, Pay-for-Performance, Stars, NQF, AHRQ and more.
Simplify the process
Roll up all claims, enrollments, accounts and charges into one patient event record for more collaborative information sharing between payers and providers.
Ensure high scores
With data insights, you can conduct easy, efficient internal audits and close gaps in care throughout the year. You can also provide timely and accurate updates on performance metrics at any point in the reporting timeframe.
What our clients say:
"Closing gaps in care is a big win for payers.”
—Analytics Consultant
"We appreciate having a system of ongoing performance monitoring."
"Better care typically means patients are staying healthier which means fewer claims will need to be paid out."
—Analytics Consultant
Analytics in action
Our intelligent platform and intuitive user interface make it easy to unlock the value of your data. Click through the screenshots below to see how we bring meaningful insights, powerful visualization and analytics innovation to facilitate even smarter decision making.
Want to talk with one of our experts on the power of analytics?