Quality Management

Unified Quality Management

Align payers, providers, pharmacies, and members to drive measurable improvements in quality performance.

Transform your quality programs

The Healthcare Intelligence Cloud enables both providers and payers to improve quality performance and deliver better care to patients.

For Providers

Seamlessly integrate risk adjustment into clinical workflows with point-of-care tools that surface suspected conditions, documentation gaps, and clinical evidence.

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For Payers

Transform your risk adjustment performance with AI-powered analytics that drive both prospective and retrospective programs.

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Engage Providers on Quality Performance at the Point of Care

Unified Quality Operations

Consolidate your entire quality program onto a single, NCQA-certified platform that supports year-round quality monitoring across all lines of business. Our high-frequency measure engine processes data continuously, providing real-time insights into quality performance and enabling proactive gap closure strategies.

Pharmacy and Provider Gap Closure

Leverage our national pharmacy network to deploy pharmacy quality programs and enable provider-led gap closure at healthcare organizations across the country – all while tracking progress in real-time through a unified dashboard.

Regulatory Excellence

Simplify your regulatory reporting with end-to-end HEDIS submissions support. Our platform automates chart chasing and abstraction workflows while maintaining complete audit trails. NCQA-certified sampling and measure calculation ensures accuracy and compliance across all quality programs.

Elevate Quality Metrics and Meet Compliance with Quality Management

Seamless Clinical Workflows

Experience quality management that works the way you do. Our EHR-integrated solutions deliver care gap notifications and quality measure documentation within your existing workflows. Automated coding suggestions ensure you can focus on patient care while meeting quality objectives.

Performance Optimization

Gain immediate visibility into your quality performance through real-time scorecards and peer benchmarking. Track your progress in value-based programs and identify opportunities for improvement with intuitive analytics and trending tools.

Care Team Enablement

Empower your entire care team with tools designed to close gaps efficiently. From pre-visit planning to standing orders automation, we provide the resources needed to deliver high-quality care consistently.

The Quality Management Suite

Quality Measure Support

Support for all major quality programs including HEDIS®, Stars, and ACO measures, with real-time monitoring and risk-adjusted benchmarking. Custom measure development ensures you can track what matters most to your organization.

Engagement Tools

Enable seamless collaboration between providers and pharmacies while coordinating member outreach campaigns. Integrated communication tools and patient education resources ensure everyone stays aligned on quality initiatives.

Analytics & Insights

Transform data into actionable insights through sophisticated analytics that highlight opportunities for improvement. Track ROI and population health metrics while predicting future performance trends.

Technology Foundation

Built on a FHIR-based architecture with NCQA-certified data aggregation, our platform ensures reliable data integration and secure information exchange. Automated workflows streamline everything from chart chase orchestration to member outreach, while maintaining full regulatory compliance and audit readiness.

Frequently Asked Questions

What quality programs does your platform support?

Our platform provides comprehensive support across multiple quality programs through a single integrated system. This includes HEDIS, Star Ratings, HEDIS, UDS, MSSP, ACO REACH, MIPS, etc. With our NCQA-certified measure engine, we support both standard and custom measures, enabling health plans to manage all their quality reporting requirements through one solution.

How do you support HEDIS® reporting and submissions?

We provide end-to-end HEDIS® reporting support through our NCQA-certified solution. This includes administrative, hybrid, and ECDS measure calculation, certified sampling, automated chart chase and abstraction workflows, performance dashboards, and complete audit support. Our platform handles everything from data collection through final IDSS/PLD submission, ensuring compliance with NCQA requirements while streamlining the entire process.

What capabilities do you offer for care gap closure?

Our platform enables multi-channel gap closure through coordinated interventions across providers, pharmacies, and care teams. We offer EMR-integrated provider alerts through a point-of-care solution called InNote, and a pharmacy engagement solution called EQUIPP®. Health plans can track gap closure activities in real-time and orchestrate interventions across their entire network, achieving up to 90% year-end gap closure rates.

How does your pharmacy quality network support quality improvement?

Our platform connects health plans with 95% of pharmacies nationwide through EQUIPP®, enabling enhanced pharmacy services such as blood pressure readings and A1C screenings. Pharmacies can view patient opportunities, perform outreach, and document screenings directly in the platform.

What kind of data integration and management capabilities do you provide?

As an NCQA-certified Data Aggregator, we offer comprehensive data management capabilities built on a USCDI/FHIR-based platform. This includes extensive pre-built data connectors for claims, EMRs, HIEs, and labs, 7,000+ data quality rules, unified data modules for administrative and clinical data, and advanced security features including HITRUST and SOC2 compliance. Our platform ensures high-quality data integration while maintaining complete audit trails.

How do you support year-round quality monitoring and improvement?

Our solution provides continuous quality monitoring through high-frequency measure calculation and real-time performance dashboards. Quality teams can access rate performance reporting, gap closure surveillance, and detailed KPIs throughout the year. We offer automated targeting and workflow tools for outreach coordinators, point-of-care insights for providers, and comprehensive analytics for tracking progress against benchmarks and goals. This enables proactive quality improvement rather than just annual reporting.