PRODUCTS
Perform+ Regulatory
Accelerate gap closure and improve regulatory performance
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Overview
Perform+ Regulatory enables healthcare organizations to manage their regulatory reporting requirements while driving improvement in quality scores for programs like HEDIS, MIPS and ACO. Perform+ Regulatory enables comprehensive, insight-driven quality improvement and provider engagement across multiple regulatory programs. It also provides real-time compliance updates and highly configurable automated workflows for improved efficiency and focused measure prioritization.
Perform+ Regulatory empowers quality and care management teams to:
i) Drive HEDIS, Star and state regulatory needs through a unified platform
ii) Prioritize and accelerate gap closure
iii) Leverage advanced analytics (including AI/ML) across population and value-based programs
iv) Improve efficiencies across HEDIS compliance and Medical Record Review
Perform+ Regulatory: Advantage
Perform+ Regulatory gives health plans comprehensive insight to drive quality, improve provider engagement and enhance regulatory performance
Vertically Integrated Solution Suite
Performance improvement for multiple programs, for HEDIS and beyond (integrated Risk, Population health, Provider performance etc.)
AI/ ML Performance Library
Extended library of AI/ML use cases to improve quality planning decisions, segmentation, chase intelligence and data enrichment.
FHIR Enablement
Available accelerators and expertise for executing FHIR/Interop use cases for Quality based supplemental data collection, ‘gaps in care’ alerts.
Near Real Time Computation
Ability to carry out daily / weekly processing for accelerated coordination and scale at the speed of business.
Self Service Informatics
Variety of self-service capabilities viz. Rule authoring, Audit 360 etc. to extend time savings and fast track business decisions.
Optimize Provider Outreach
Reduced provider abrasion and increase in provider collaboration by identifying the right provider to chase and to close the right gaps.
Vertically Integrated Solution Suite
Performance improvement for multiple programs, for HEDIS and beyond (integrated Risk, Population health, Provider performance etc.)
AI/ ML Performance Library
Extended library of AI/ML use cases to improve quality planning decisions, segmentation, chase intelligence and data enrichment.
FHIR Enablement
Available accelerators and expertise for executing FHIR/Interop use cases for Quality based supplemental data collection, ‘gaps in care’ alerts.
Near Real Time Computation
Ability to carry out daily / weekly processing for accelerated coordination and scale at the speed of business.
Self Service Informatics
Variety of self-service capabilities viz. Rule authoring, Audit 360 etc. to extend time savings and fast track business decisions.
Optimize Provider Outreach
Reduced provider abrasion and increase in provider collaboration by identifying the right provider to chase and to close the right gaps.
Measure Engine
BI-Clinical powered Measure Engine with flexibility to configure runs at the speed of business, produces measure output with in-depth auditability and available in various formats to drive active collaboration and quality improvement.
Measure Library
Comprehensive measure library with 750+ measures across HEDIS, CMS MA Stars, CMS Coreset and other state/custom measures
Rules Management Module
Differentiated ability to author / modify HEDIS like measures along with configuration of NCQA allowable adjustments
Audit 360
Ability to perform population cohort study and single member compliance study across measure-conditions to swiftly identify focused improvement areas
Run Compare
Allows to compare two measure runs between prior system and Perform+ Regulatory or any two ongoing Perform+ Regulatory runs for variance study across measure-conditions
Measure Library
Comprehensive measure library with 750+ measures across HEDIS, CMS MA Stars, CMS Coreset and other state/custom measures
Rules Management Module
Differentiated ability to author / modify HEDIS like measures along with configuration of NCQA allowable adjustments
Audit 360
Ability to perform population cohort study and single member compliance study across measure-conditions to swiftly identify focused improvement areas
Run Compare
Allows to compare two measure runs between prior system and Perform+ Regulatory or any two ongoing Perform+ Regulatory runs for variance study across measure-conditions
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Medical Record Review
Integrated Medical Record Review with administrative measure engine for Real time compliance update along with configurable automated workflow for improved efficiency and focused prioritization.
Intelligent Chase Logic
Comprehensive library of chase rules with granular configurability along with inbuilt chase prioritization scoring for provider outreach.
Flexible Campaign Management
Campaign management module flexibility to create various campaign groupings, customizable provider letter complemented by automated workflow for chase planning and chart upload.
Seamless Abstraction
Split screen view for abstraction with real time compliance check and error codes for improved accuracy. Enables quick go-live for new or additional measures through configurable, data-driven screen builder.
Operational Reports
Out of the box operational report to review efficiency and areas of focus across various workflows along with measure wise compliance impact through Medical Record Review projects
Intelligent Chase Logic
Comprehensive library of chase rules with granular configurability along with inbuilt chase prioritization scoring for provider outreach.
Flexible Campaign Management
Campaign management module flexibility to create various campaign groupings, customizable provider letter complemented by automated workflow for chase planning and chart upload.
Seamless Abstraction
Split screen view for abstraction with real time compliance check and error codes for improved accuracy. Enables quick go-live for new or additional measures through configurable, data-driven screen builder.
Operational Reports
Out of the box operational report to review efficiency and areas of focus across various workflows along with measure wise compliance impact through Medical Record Review projects
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Submission
Unified module for seamless error free submission across NCQA HEDIS®, CMS and other State agencies.
File Generation
Enables generation of IDSS file for NCQA, PLD file for CMS and other state required measure and member level files for various state submissions.
Output Reconciliation
Automated utility to reconcile IDSS and PLD data, automated validation of IDSS and PLD output accuracy along with ready to use reports for representing external audit inquiries.
File Generation
Enables generation of IDSS file for NCQA, PLD file for CMS and other state required measure and member level files for various state submissions.
Output Reconciliation
Automated utility to reconcile IDSS and PLD data, automated validation of IDSS and PLD output accuracy along with ready to use reports for representing external audit inquiries.
Analytics & Reporting
Suite of pre-built, configurable analytics tools, dashboards and rich visualizations, including HEDIS, gaps-in-care, Member 360, Measure 360, Provider 360, etc. to improve decision making and accelerate gap-closure
Out-of-the-box Starter Reports
A large set of ready reports (e.g., Quality, HEDIS, HCC, CMS Star, Provider 360, etc.) to make the solution usable from the first day
Predictive Capabilities
Data Science driven capabilities (HEDIS / Stars) to predict measure denominator qualification, compliance rate and identify focused member list for outreach.
Custom Reports
Additional flexibility to add custom reports or modify existing UI. Powerful, intuitive and easy-to-use tools for report creation and customization
Comprehensive Insights
Holistic view of provider, member and measure –rate benchmarking, rate trending, rate traceability, member drill-downs and provider scorecards
Out-of-the-box Starter Reports
A large set of ready reports (e.g., Quality, HEDIS, HCC, CMS Star, Provider 360, etc.) to make the solution usable from the first day
Predictive Capabilities
Data Science driven capabilities (HEDIS / Stars) to predict measure denominator qualification, compliance rate and identify focused member list for outreach.
Custom Reports
Additional flexibility to add custom reports or modify existing UI. Powerful, intuitive and easy-to-use tools for report creation and customization
Comprehensive Insights
Holistic view of provider, member and measure –rate benchmarking, rate trending, rate traceability, member drill-downs and provider scorecards
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Knowledge hub
Our library includes a multitude of carefully chosen blogs, articles, webinars, etc. to help stay informed about the happenings of the industry
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