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Quality Improvement Solutions

Integrated Quality Improvement Capabilities for Health Plans

Indegene's end-to-end quality improvement solutions enable health plans improve HEDIS, STAR, and ACO measures by integrating advanced analytics, medical record retrieval, and reporting capabilities.

Medicare Advantage Star Ratings Outcomes
Medicare Advantage Star Ratings Outcomes
How It Works

Our quality improvement solutions consist of STAR rating enhancement platform, member and provider engagement expert solutions, and risk-adjustment services, which enable health plans to deliver a healthy measure-level, population-level, and program-level ROI.

Solutions
End-to-end HEDIS/QRS Measurement and Reporting to Manage and Streamline HEDIS Workflow

Indegene's HEDIS Pro platform streamlines HEDIS® and other quality measures reporting and workflow processes and is currently integrated within Indegene's end-to-end Quality Measurement and Improvement solution to help health plans improve quality outcomes, including CMS STAR ratings. By identifying and prioritizing quality and care gaps at both the member and provider levels through advanced proprietary analytics, gap closure can be efficiently facilitated through effective, customized omnichannel member and provider engagement solutions. Indegene's data collection and aggregation process consists of administrative data processing and hybrid medical chart abstraction using data integration tool to aggregate data from multiple disparate sources. We leverage predictive analytics to identify and prioritize members and providers for targeted care interventions. Our proprietary reporting dashboard with drill-down functionality helps health plans to identify non-compliant members and enables them to design comprehensive quality improvement (QI) programs.

Empowering Health Plans to Aggregate Insights, Track Performance, Strategize Interventions, and Take Corrective Actions

Indegene's STAR Improvement solutions help health plans to assess their STAR ratings, identify care gaps, predict outcomes and take corrective actions by prioritizing measures, members and providers for targeted gap closure. Our solutions help in the overall analysis of health plan, identifying low-performing measures and drilling down to review member-and provider-level data to perform gap analysis. Indegene STARMAX - is our enterprise-wide STAR assessment and benchmarking platform that encourages data-driven decision making through intuitive dashboards. Its predictive analysis and drill-down capabilities help STAR team to track, predict, and analyze their STAR rating. STARMAX also assists in planning the interventions for targeted gap closure.

  • HEDIS Solutions
    End-to-end HEDIS/QRS Measurement and Reporting to Manage and Streamline HEDIS Workflow

    Indegene's HEDIS Pro platform streamlines HEDIS® and other quality measures reporting and workflow processes and is currently integrated within Indegene's end-to-end Quality Measurement and Improvement solution to help health plans improve quality outcomes, including CMS STAR ratings. By identifying and prioritizing quality and care gaps at both the member and provider levels through advanced proprietary analytics, gap closure can be efficiently facilitated through effective, customized omnichannel member and provider engagement solutions. Indegene's data collection and aggregation process consists of administrative data processing and hybrid medical chart abstraction using data integration tool to aggregate data from multiple disparate sources. We leverage predictive analytics to identify and prioritize members and providers for targeted care interventions. Our proprietary reporting dashboard with drill-down functionality helps health plans to identify non-compliant members and enables them to design comprehensive quality improvement (QI) programs.

  • STAR Improvement Solution
    Empowering Health Plans to Aggregate Insights, Track Performance, Strategize Interventions, and Take Corrective Actions

    Indegene's STAR Improvement solutions help health plans to assess their STAR ratings, identify care gaps, predict outcomes and take corrective actions by prioritizing measures, members and providers for targeted gap closure. Our solutions help in the overall analysis of health plan, identifying low-performing measures and drilling down to review member-and provider-level data to perform gap analysis. Indegene STARMAX - is our enterprise-wide STAR assessment and benchmarking platform that encourages data-driven decision making through intuitive dashboards. Its predictive analysis and drill-down capabilities help STAR team to track, predict, and analyze their STAR rating. STARMAX also assists in planning the interventions for targeted gap closure.

Benefits
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Effective care and quality gap closure by quantifying measures and devising interventions

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Improved member health and boosted patient adherence and compliance for superior member health outcomes

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Augmented financial performance by improving focus and performance across quality measures to maximize incentives

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Accurate measurement of quality and compliance adherence and design interventions for adherence

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100% CMS guidelines compliance across HEDIS and STAR cycle with all measures being NCQA compliant

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Coordinated actions through single source of truth

Related Resources
resources
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