Daily HEDIS Reporting Now Possible with SCORE+

CitiusTech’s SCORE+ enables you to standardize, compare, optimize, report and enhance your HEDIS capability in near real-time environment

In the age of value based healthcare and reimbursement, health plans face increasing pressure to improve their bottom-line in an uncertain environment. As a result, regulatory incentives such as CMS Star ratings, and underlying HEDIS performance, have a new meaning. With stringent audit timelines and complex data collection processes, health plans need to aggregate and manage multiple types of data (e.g. claims data, clinical data, supplemental data) from a wide spectrum of stakeholders across the care continuum. Frequent generation of HEDIS reports can enable health plans to improve compliance, engage providers, and close gaps in real-time. However, due to technology and performance limitations, health plans are only able to execute monthly or quarterly HEDIS compliance runs.

CitiusTech offers SCORE+ for HEDIS, a comprehensive solution that enables health plans to carry out HEDIS compliance runs in near real-time. The solution is based on CitiusTech’s NCQA certified BI/analytics platform, BI-Clinical, which provides 700+ pre-built KPIs across a wide range of quality reporting needs. With a comprehensive set of NCQA mandated validations as well as enhanced reports, SCORE+ for HEDIS enables health plans to generate HEDIS reports faster than almost every other HEDIS reporting application in the market.

Improve your HEDIS SCORE+ today!

  • NCQA Certified
  • Rules Management
  • Comprehensive Measure Library
  • Intelligent Chart Chase
  • Rapid Measure Updates

Achieve Daily Runs for HEDIS Submission

BI-Clinical has a high performance rules-engine that enables organizations to carry out daily prospective HEDIS compliance runs, reduce turnaround time & accelerate gap closure.

Key Service Offerings, Sustained Engineering, CitiusTech
NCQA Compliant Validations & Reports

CitiusTech’s BI-Clinical platform is NCQA certified for 2019 HEDIS® hybrid measures and systematic sampling and is currently pursuing NCQA certification for all HEDIS 2019 measures. All relevant functional modules such as the clinical/ chart data collection & audit reporting functionalities fully comply with NCQA requirements.

Simplified yet comprehensive Rules Management

BI-Clinical offers a highly configurable rules engine, support for real time clinical alerts and data models like UDMH, OMOP, FHIM. It includes a seamlessly integrated Rules Management Module to provide clients / end users an easy to use, DIY interface to author, version, audit, test & manage both standard HEDIS measure definitions as well as custom measure versions.

Custom Measures

The Rules Management Module allows users to define, modify, test and manage create custom measures, over an above the existing library of pre-configured HEDIS measures. Health plans have the flexibility to enable self-service configuration without needing to rely on external teams.

Accelerated Measure Updates & Frequent Runs

With a high-performance data-architecture, BI-Clinical enables health plans to carry out multiple prospective HEDIS compliance runs every month. The highly flexible and configurable Rules Management Module allows you to roll out new HEDIS measures within 60 days post release from NCQA.

Clinical Data Collection

Dedicated modules for clinical as well as supplementary data collection including mobile-enabled, workflow-driven onsite as well as remote chart retrieval from provider partners. Seamless integration with provider portals or existing document management systems. Optional accelerators to ingest, process & use HL7, CCDA messages as well as data quality accelerators

Clinical Decision Support

Powerful features to integrate evidence-based information with the care delivery process. Integrates with multiple healthcare applications, provides a single view of analytics, and enables decision making for providers and clinicians at the point of care. Helps organizations avoid errors, improve member engagement and identify potential gaps-in-care.

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