Key Highlights:
- Innovaccer Inc., a pioneer in healthcare artificial intelligence, has rolled out a novel quality management and reporting solution tailored specifically for health plans.
- This comprehensive platform enables health plans to streamline workflows, enhance member health outcomes, and attain superior quality ratings.
Addressing Challenges in Healthcare Quality Management
For a long time, health plans have struggled to efficiently handle quality and reporting obligations. By providing an NCQA-certified platform that combines data ingestion, quality control, member interaction, and reporting into a single workflow, Innovaccer’s solution takes on these problems head-on.
“With the addition of PQS to the Innovaccer family, we are taking a significant leap forward in our mission to revolutionize healthcare through innovation,” said Abhinav Shashank, co-founder and CEO of Innovaccer. The quality monitoring and reporting system represents a major advancement in the use of data and artificial intelligence to advance value-based care. Together with creating a smooth clinical data interchange with payers and pharmacies, we are strengthening our capacity to enhance member health outcomes. The future of healthcare delivery is being shaped by the payer, provider, and pharmacy working together to create a linked ecosystem.”
Enhanced Member Care
This rollout incorporates pharmaceutical data and functionality, and comes after Innovaccer’s strategic acquisition of PQS (pharmaceutical Quality Solutions). Stronger cooperation amongst payers, providers, and pharmacies is fostered by this partnership, which makes it easier to identify and close care gaps and, eventually, improves member satisfaction and health.
Setting Up Health Plans for Value-Based Care Success
With the aid of this solution, health plans will be able to successfully manage the shift to value-based care and thrive in the dynamic environment of healthcare quality. The following are some salient characteristics:
- Unified Data Model: The system, which is based on HL7/FHIR and USCDI standards, effectively combines clinical data and claims for effective management. Processes for quality management are streamlined by automated data intake and auditable onboarding that guarantee data accuracy.
- NCQA-Certified Measure Engine: An extensive collection of verified quality measures, such as HEDIS®, Stars, QRS, and others, are available on the site. It also facilitates a seamless transition to digital quality, provides custom measure creation, and accommodates a variety of reporting requirements.
- Enhanced Gap Closure Engagement: By utilizing PQS’s experience, Innovaccer offers a range of gap closure interfaces, giving users a multitude of alternatives for improving quality. The solution’s mobile/web portal options and EHR-agnostic overlay enable smooth provider participation at the point of care. Tools designed specifically for pharmacies maximize involvement to find and report on gap closure opportunities.
- Streamlined Quality Reporting: End-to-end capabilities for HEDIS®, IDSS, and PLD reporting across Hybrid, ECDS, and Admin Measures are provided by the integrated platform. bolstered by an audit support dashboard, record retrieval, abstraction, and review capabilities.
- Continuous Quality Improvement: Health plans can now view results at scale with member-centric quality performance dashboards. Drill-down capabilities for the organizational hierarchy allow for the examination of operational and performance metrics at different levels. This facilitates the tracking of advancements in relation to CMS Star Ratings, QualityCompass benchmarks, and customized targets, hence enabling more focused outreach initiatives.
A major step forward in tackling the complexity of healthcare quality management has been made with Innovaccer’s introduction of a ground-breaking quality management system designed specifically for health plans. With the integration of data-driven insights, optimized workflows, and improved member engagement, this solution gives health plans the edge they need to successfully negotiate the rapidly changing value-based care landscape. With an emphasis on enhancing member health outcomes and encouraging cooperation between pharmacists, payers, and clinicians, Innovaccer is paving the way for an effective, efficient, and member-centric healthcare delivery model of the future, read more about Innovaccer Launches Quality Management Solution for Health Plans at https://hitconsultant.net/
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