Quality Improvement Solution
Quality has become the foundation for health plan success across all lines of business, especially government programs, where Star Ratings and HEDIS® measures represent significant revenue risks and opportunities.
Overview
Quality metrics provide documentation and validation of the care provided to individual members and populations. These metrics also inform strategy, drive performance, monitor providers and vendors, and help direct care.
How Jiva Helps With Quality Measurement
Intelligent Automation
Automated workflows leverage the Jiva Sentinel Rules Engine and our world-class clinical content resources to give teams a “next best action” orientation and the tools they need to ensure optimal interventions.
Analytics and Reporting
The healthcare industry continues to move in the direction of increasing high-value care and eliminating wasteful, medically unnecessary services. Value-based initiatives are similarly growing both in numbers and sophistication. From simple pay-for-performance (P4P) to more intricate risk-bearing arrangements, the ability to measure, trend, report and document return on investment (ROI) is critical. Whether or not a value-based care agreement names quality measures as criteria, quality remains a fundamental component of performance.
Clinical Intelligence
Our growing library of continuously updated clinical content and care pathways reduces variability, ensures consistent reviews, and includes high-value, member-facing educational materials.
Experienced Advisors
Our quality program advisors are seasoned veterans with extensive real-world experience in value-based transformation. They focus on defining a customized set of core competencies and guiding process and technology implementations to achieve consistently high-quality metrics.
Who We Serve
