ELEVATE! QUALITY INSIGHTS
ADVANTMED’S CLOUD-BASED, NCQA-CERTIFIED SOFTWARE
The quality optimization process begins when ELEVATE! Quality Insights 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 identifies service gaps for all product lines, including Medicare, Medicaid, and ACA health plans. The solution builds off the information produced by Advantmed HEDIS® measures or output from other HEDIS reporting tools.
Action is enabled through an optimal combination of services, such as medical record retrieval, HEDIS abstraction by clinical reviewers, identification of documentation/service gaps, and member and provider engagement services to close gaps.
ELEVATE! QUALITY INSIGHTS FEATURES AND BENEFITS
NCQA-certified annually since 2007.
Provides reports, charts, and graphs depicting HEDIS scores and measure ratings, population selection, and member positive/negative numerators, denominators and exclusions.
Presents drill-down functionality to any of the provider, reviewer, member and qualifying event levels, providing insights into the drivers of results and key information to support quality improvement activities.
Handles everything necessary for annual submission of HEDIS/QRS results, and monitors quality improvement on a monthly basis.
Priced at or below the majority of competitive HEDIS products and services.
Integrates into Advantmed’s ELEVATE! health information management platform to provide transparency into the status and progress of all quality measurement and improvement activities.
Presents drill-down functionality at the provider-level, whether statistical sampling for hybrid-eligible measures or member engagement focused on closing service gaps.
Handles all the preparation for submitting patient-level data to CMS and summary-level data to NCQA’s Interactive Data Submission System (IDSS).
Allows management to track reviewer progress, compare results between reviewers and measures, and monitor the changes to the HEDIS numerators, denominators and exclusions through review in real-time.
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
- Substantiate MRRV
- Support submission of IDSS
- Monitor progress of HEDIS project and quality improvement activities through monthly runs
- Identify service gaps from selected measures
- Member Engagement services to close gaps
- Facilitate insight into provider performance