What You Should Know:
– Innovaccer Inc., a leader in healthcare artificial intelligence, has unveiled a quality management and reporting solution designed specifically for health plans.
– The comprehensive platform empowers health plans to streamline workflows, improve member health outcomes, and achieve higher quality ratings.
Addressing Challenges in Healthcare Quality Management
Health plans have long grappled with managing quality and reporting requirements effectively. Innovaccer’s solution tackles these challenges head-on, offering an NCQA-certified platform that integrates data ingestion, quality management, member engagement, and reporting into a single, unified workflow.
"With the addition of PQS to the Innovaccer family, we are taking a giant leap forward in our mission to transform healthcare through innovation,” stated Abhinav Shashank, cofounder and CEO at Innovaccer. "The quality management and reporting solution marks the beginning of significant steps in advancing value-based care through data and AI. We're enhancing our ability to improve member health outcomes and establishing a seamless clinical data exchange with payers and pharmacies. Together, we're creating a connected ecosystem of payer, provider, and pharmacy, shaping the future of healthcare delivery."
Improved Member Care
This launch follows Innovaccer’s strategic acquisition of PQS (Pharmacy Quality Solutions). By integrating pharmacy data and functionalities, the solution fosters stronger collaboration between payers, providers, and pharmacies. This collaborative approach enables more effective identification and closure of care gaps, ultimately leading to improved member health and satisfaction.
Equipping Health Plans for Value-Based Care Success
This solution equips health plans with the tools and capabilities they need to thrive in the evolving healthcare quality landscape and navigate the transition to value-based care. Here are some key features that empower success:
- Unified Data Model: Built on USCDI and HL7/FHIR standards, the solution seamlessly integrates claims and clinical data for efficient management. The highly auditable onboarding process and automated data ingestion ensure data accuracy, streamlining quality management processes.
- NCQA-Certified Measure Engine: A comprehensive library of certified quality measures is readily available, including HEDIS®, Stars, QRS, and more. Additionally, the platform offers the ability to build custom measures, supporting diverse reporting requirements and facilitating a smooth digital quality transition.
- Enhanced Gap Closure Engagement: Leveraging PQS’s expertise, Innovaccer provides a wide array of gap closure interfaces, offering multiple options for improving quality. The solution facilitates seamless provider engagement at the point of care through an EHR-agnostic overlay and mobile/web portal options. Pharmacy-specific tools optimize engagement for identifying and reporting gap closure opportunities.
- Streamlined Quality Reporting: The integrated platform offers end-to-end functionality for HEDIS®, IDSS, and PLD reporting across Hybrid, ECDS, and Admin Measures. This robust functionality is backed by capabilities for record retrieval, abstraction, review, and an audit support dashboard.
- Continuous Quality Improvement: Member-centric quality performance dashboards empower health plans to visualize results at scale. Organizational hierarchy drill-down features enable analysis of measure performance and operational details at various levels. Health plans can leverage this data to track progress against CMS Star Ratings, QualityCompass benchmarks, and custom targets, further enabling targeted outreach campaigns.
