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 one’s competitors.
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. We assign confidence levels to the likelihood of closing each gap at the individual provider- and member-level, priority scores to the revenue impact of addressing each quality metric, and grades for both clinical performance and coding efficacy to providers and medical groups – all for the purpose of optimally deploying your finite resources to maximize financial impact and document care quality.
Qualit8 is the Quality Command Center in Pulse8’s ongoing journey to provide risk-bearing entities with the most pragmatic gap closure solution available anywhere.