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Quality360

A tool for health insurance companies to identify gaps in their quality measures.

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Clair360 | Quality360 | Delivering value-based care through HEDIS Reporting Solutions​

About Quality360

Quality360, a cutting-edge Snowflake Native App designed to transform the way payers and providers analyze patient data for HEDIS measures. Quality360, is an affordable tool to empower your quality program, which is also certified by NCQA for HEDIS measures. It offers a comprehensive suite of tools to streamline data analysis, facilitate data conversion, and ensure effortless submission to NCQA for star ratings.

Quality360 helps your organization to run scheduled quality analysis and ensure Data Security and Compliance. This provides you with insights such as

  • Identification of Improvement Areas.
  • Decision-making for enhancing care quality.
  • Comprehensive analysis of quality data.

Why HEDIS?​

Healthcare Payers (Insurers)

To evaluate care quality, select top providers, and ensure regulatory compliance to enhance member satisfaction and health outcomes.​

Healthcare Providers

To monitor, and enhance care quality, meet contractual obligations, and attract patients by showcasing high-quality care.​

Accountable Care Organizations (ACOs)

To coordinate care, demonstrate value-based care excellence, and achieve financial incentives through quality and cost-effective care.​

Managed Care Organizations (MCOs)

To deliver high-quality, cost-effective care to members, meet regulatory requirements, and grow their membership base.​

Third-Party Administrators (TPAs)

To ensure compliance, provide data-driven insights, and optimize healthcare benefits for self-insured employers and insurers.​

Quality Improvement Organizations (QIOs)

To evaluate care quality, select top providers, and ensure regulatory compliance to enhance member satisfaction and health outcomes.​

Features of Quality360

Improve healthcare quality performance with actionable data insights to close gaps in value-based care​.

  • Real-time Data Processing for instant insights and up-to-date HEDIS measures​.
  • Efficient Reporting Engine Streamlines HEDIS reporting, saving time and resources​.
  • Credibility and reliability are ensured through NCQA certification, guaranteeing compliance with HEDIS standards.
  • Robust security measures to protect sensitive healthcare data and ensure HIPAA compliance​.
  • Easy setup and configuration through intuitive admin UI and Snowflake Native App framework​.
Features of Quality360

Benefits with Quality360

1

Accuracy

Improve HEDIS score accuracy,
reducing compliance risks.​

2

Compliance Assurance

Stay current with evolving HEDIS
reporting requirements.​

3

Cost Reduction

Cut operational costs by optimizing
resource allocation.​

4

Patient Outcomes

Enhance patient care through quality
improvements.​

Enhance healthcare quality, close gaps in value-based care effectively. Schedule a Free Demo.
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Frequently Asked Questions

HEDIS stands for Healthcare Effectiveness Data and Information Set. It is a set of performance measures used to assess the quality of healthcare services provided by health plans and healthcare organizations. HEDIS measures cover a wide range of areas, including preventive care, chronic disease management, behavioral health, and patient experience.

HEDIS measures are used by health plans, employers, and regulatory bodies to evaluate and compare the performance of healthcare organizations. These measures provide standardized data on various aspects of care, allowing for benchmarking, identification of areas for improvement, and monitoring of quality over time.

HEDIS measures cover different dimensions of healthcare quality. Some examples include:

  1. Breast cancer screening: This measure assesses the percentage of eligible women who receive appropriate breast cancer screenings, such as mammograms.
  2. Childhood immunization status: This measure evaluates the percentage of children who receive recommended vaccinations within the appropriate age ranges.
  3. Diabetes care: This measure examines the management of diabetes by assessing various indicators, such as HbA1c testing, eye exams, and kidney disease monitoring.
  4. Antidepressant medication management: This measure assesses the follow-up care provided to patients diagnosed with depression, including medication management and coordination with other healthcare providers.

HEDIS measures serve as a framework for quality improvement efforts. By measuring and comparing performance across different organizations, healthcare providers can identify areas where they are excelling and areas that need improvement. These measures provide valuable data and insights that can drive evidence-based interventions, process improvements, and ultimately enhance the quality of care provided to patients.

HEDIS measures are not mandatory, but they are widely used and recognized as a standard for measuring healthcare quality. Health plans and healthcare organizations voluntarily report their performance on HEDIS measures to demonstrate their commitment to quality improvement and to meet the requirements of accrediting bodies and regulatory agencies.

Organizations can improve their performance on HEDIS measures by implementing evidence-based practices, care protocols, and quality improvement initiatives. This may involve enhancing preventive care services, implementing care coordination processes, optimizing electronic health record systems, and promoting patient engagement and education. Analyzing performance data, identifying gaps, and implementing targeted interventions are key steps in improving HEDIS scores.

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