Products and Services

 
Data on a Touch Pad

Improve My Quality Measure Rates

Full service management and optimization of quality programs including rate improvement, member experience, vendor management, medical record review, submission support, audit support and training

Quality Operations Management

Rapid Quality Assessment

Comprehensive evaluation of quality programs with focus on HEDIS® operations, quality improvement, member experience and operational integration

Member Experience Measurement and Improvement

Monitor and predict your experience measure rates with proprietary metrics and customized analytics, target and improve the processes that influence member experience

eQuaFive™

Quantify the impact of social determinants of health on quality performance and identify opportunities to improve health equity

DDQE

Data quality and completeness profiling tool to measure and improve accuracy of data used for quality measures

Quality Data System Transition Planning and Management

Operational and technical support for system migration including rate continuity, ETL mapping, data quality, organizational readiness and vendor selection

Digital Quality Measure Transition

Framework to ease the transition to digital measures including data integration, roadmaps and tools needed for a true ROI

Value-Based Payment Development and Evaluation

Alternative payment models, frameworks and program evaluations for primary care, cardiac surgery and orthopedics

Health Economics Data Modeling and Forecasting

Medical expense and utilization trend analysis and forecasting, clinical intervention effectiveness, disease progression modeling

Doctor's Appointment

Improve My Medicare Star Ratings

CMS Star Rating Program Optimization

Full service management and optimization of Stars programs including rating projections, HOS and CAHPS strategy, vendor management and integration, data analytics and measurement

eQuaFive™

Quantify the impact of social determinants of health on quality performance and identify opportunities to improve health equity

Operational and technical support for system migration including rate continuity, ETL mapping, data quality, organizational readiness and vendor selection

Quality Data System Transition Planning and Management

SCO and PACE Program Optimization

Analytics to improve Stars and risk adjustment programs for SCO and PACE plans with focus on quality programs, revenue optimization and projection, operational integration and undocumented risk

Member Experience Measurement and Improvement

Monitor and predict your experience measure rates with proprietary metrics and customized analytics, target and improve the processes that influence member experience

Digital Quality Measure Transition

Framework to ease the transition to digital measures including data integration, roadmaps and tools needed for a true ROI

Forecast Star ratings, evaluate future impacts of plan performance and regulatory updates, and identify risks and opportunities

Medicare Stars Modeler

DDQE

Data quality and completeness profiling tool to measure and improve accuracy of data used for quality measures

Health Economics Data Modeling and Forecasting

Medical expense and utilization trend analysis and forecasting, clinical intervention effectiveness, disease progression modeling

 
Dentist Appointment

Improve My Members' Experience

Member Experience Measurement and Improvement

Monitor and predict your experience measure rates with proprietary metrics and customized analytics, target and improve the processes that influence member experience

CMS Star Rating Program Optimization

Full service management and optimization of Stars programs including rating projections, HOS and CAHPS strategy, vendor management and integration, data analytics and measurement

eQuaFive™

Quantify the impact of social determinants of health on quality performance and identify opportunities to improve health equity

Value-Based Payment Development and Evaluation

Alternative payment models, frameworks and program evaluations for primary care, cardiac surgery and orthopedics

SCO and PACE Program Optimization

Analytics to improve Stars and risk adjustment programs for SCO and PACE plans with focus on quality programs, revenue optimization and projection, operational integration and undocumented risk

 
Stethoscope on the Cardiogram

Optimize My Risk Score

Rapid Risk Adjustment Assessment

Comprehensive evaluation of risk programs with focus on revenue optimization and projection, operational integration and undocumented risk

Value-Based Payment Development and Evaluation

Alternative payment models, frameworks and program evaluations for primary care, cardiac surgery and orthopedics

SCO and PACE Program Optimization

Analytics to improve Stars and risk adjustment programs for SCO and PACE plans with focus on quality programs, revenue optimization and projection, operational integration and undocumented risk

Health Economics Data Modeling and Forecasting

Medical expense and utilization trend analysis and forecasting, clinical intervention effectiveness, disease progression modeling

 
Kids Doctor Checkup

Improve Equity in Healthcare

eQuaFive™

Quantify the impact of social determinants of health on quality performance and identify opportunities to improve health equity

Digital Quality Measure Transition

Framework to ease the transition to digital measures including data integration, roadmaps and tools needed for a true ROI

Member Experience Measurement and Improvement

Monitor and predict your experience measure rates with proprietary metrics and customized analytics, target and improve the processes that influence member experience

Rapid Quality Assessment

Comprehensive evaluation of quality programs with focus on HEDIS® operations, quality improvement, member experience and operational integration

Value-Based Payment Development and Evaluation

Alternative payment models, frameworks and program evaluations for primary care, cardiac surgery and orthopedics

Health Economics Data Modeling and Forecasting

Medical expense and utilization trend analysis and forecasting, clinical intervention effectiveness, disease progression modeling

 
Graphs

Predict the Future

Medicare Stars Modeler

Forecast Star ratings, evaluate future impacts of plan performance and regulatory updates, and identify risks and opportunities

Member Experience Measurement and Improvement

Monitor and predict your experience measure rates with proprietary metrics and customized analytics, target and improve the processes that influence member experience

Health Economics Data Modeling and Forecasting

Medical expense and utilization trend analysis and forecasting, clinical intervention effectiveness, disease progression modeling

Value-Based Payment Development and Evaluation

Alternative payment models, frameworks and program evaluations for primary care, cardiac surgery and orthopedics

Rapid Risk Adjustment Assessment

Comprehensive evaluation of risk programs with focus on revenue optimization and projection, operational integration and undocumented risk

 
 
Team Meeting

Train My Team

Health Care Quality Education Training and Mentoring

Customized training programs to ensure that your staff has the skills and knowledge to effectively manage quality and clinical analytics

Quality Operations Management

Full service management and optimization of quality programs including rate improvement, member experience, vendor management, medical record review, submission support, audit support and training

CMS Star Rating Program Optimization

Full service management and optimization of Stars programs including rating projections, HOS and CAHPS strategy, vendor management and integration, data analytics and measurement

SCO and PACE Program Optimization

Analytics to improve Stars and risk adjustment programs for SCO and PACE plans with focus on quality programs, revenue optimization and projection, operational integration and undocumented risk

Digital Quality Measure Transition

Framework to ease the transition to digital measures including data integration, roadmaps and tools needed for a true ROI

A woman at the office overlooking the ci

Validate My Data

DDQE

Data quality and completeness profiling tool to measure and improve accuracy of data used for quality measures

Quality Data System Transition Planning and Management

Operational and technical support for system migration including rate continuity, ETL mapping, data quality, organizational readiness and vendor selection

Digital Quality Measure Transition

Framework to ease the transition to digital measures including data integration, roadmaps and tools needed for a true ROI

Quality Operations Management

Full service management and optimization of quality programs including rate improvement, member experience, vendor management, medical record review, submission support, audit support and training

Health Economics Data Modeling and Forecasting

Medical expense and utilization trend analysis and forecasting, clinical intervention effectiveness, disease progression modeling

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)