Quality Improvement

ELEVATE! Quality Insights® is Advantmed’s comprehensive quality measurement and improvement solution for health plans, managed care organizations and other risk-bearing entities.

The quality optimization process begins with our cloud-based software containing NCQA-certified HEDIS® measures, which calculates all HEDIS administrative measures as well as systematic hybrid samples for all hybrid-eligible measures included in NCQA’s Technical Specifications. ELEVATE! Quality Insights also identifies service gaps for all product lines, including commercial, Medicare, Medicaid and Health Insurance Exchange plans. Uniquely, the ELEVATE! Quality solution builds off of the information produced by our own HEDIS software or the output from other HEDIS reporting tools.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Advantmed incorporates ELEVATE! Quality Insights into our ELEVATE! HealthcareTM platform providing ongoing insights to understand the drivers of quality while also providing the ability to take action to ELEVATE! Quality through the optimal combination of services such as medical record retrieval, medical record abstraction by clinical reviewers, identification of documentation or service gaps and both member and provider engagement services that close those gaps.

Summary of ELEVATE! Quality Insights, Advantmed's end-to-end quality measurement and improvement solution

  • Fully-managed import of all key health plan data
  • Produce all HEDIS measures
  • Produce statistical samples for hybrid-eligible measures
  • Specify chase logic for prioritization of medical record retrieval
  • Medical record retrieval services
  • Medical Record Abstraction
  • Support submission of IDSS
  • Substantiate MRRV
  • Monitor progress of HEDIS project and quality improvement activities through monthly runs
  • Identify service gaps from selected measures

Learn more about our solutions today.