Quality Solutions
Improve quality with a comprehensive, innovative approach to manage HEDIS® performance.
Enhance clinical quality performance
Rising medical costs, affordability pressure, ever-changing reimbursement models, increased regulatory requirements and public reporting cause health plans to increase focus on quality metrics.
Multiple vendors can be costly. By enhancing clinical quality performance, health plans can improve health outcomes and reduce the cost of care.
Leverage a powerful reporting solution
Our comprehensive quality measures reporting solution helps you:
- Minimize data transfer
- Expedite the audit process
- Streamline all measures activity to maximize efficiency and help ensure successful NCQA, CMS and state submissions
We’re committed to help you maximize data and processes to increase accuracy and completeness of HEDIS and other quality program scores and performance:
- Cloud-based HEDIS reporting system
- Medical record review support
- Audit management
- Performance assessment
Comprehensive quality management
Our solutions feature unique differentiators, helping meet the unique needs and desired results for health plans.
Comprehensive quality measurement engine
The quality measurement engine has retrospective services that include HEDIS medical record review, measurement reporting and submissions. The engine also has prospective services that include supplemental data collection and quality analytics as as service.
A proactive approach to prospective quality measurement
Drive quality programs in the measurement year by identifying gaps in care while reducing retrieval costs for the upcoming season. An integrated comprehensive quality and risk adjustment process may reduce provider abrasion.
- Supplemental data collection and review
- Quality analytics as a service
Retrospective services bring your quality efforts full circle
We help health plans maximize data and processes to increase accuracy and completeness of HEDIS and other quality program scores and performance. By enhancing clinical quality performance, health plans can improve health outcomes and reduce the cost of care.
- Measurement reporting and submissions
- Maximize HEDIS collection and streamline medical record review processes
Fact sheet
Medical Record Review
Learn how Optum can help maximize HEDIS collection and streamline medical review processes.
Overview
Quality Solutions
Learn how we enable health plans to manage regulatory quality measurement and reporting.
Fact sheet
Quality management
Learn how to maximize data and processes to increase accuracy and completeness of HEDIS and other quality program scores and performance.
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).