A Targeted Approach to Drive Improved Health Plan Performance

The key drivers of health plan performance include Care Quality and Risk Adjustment. Innovaccer’s Risk and Quality Management solution helps payers collaborate with providers. Working together to close coding and quality gaps improves quality metrics and risk adjustment and optimizes health plan performance.

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Risk Adjustment Solution
Identify and close coding gaps based on clinical and claims data. Enable providers to improve coding accuracy by providing them with actionable insights.
  • Identify dropped or suspect codes.
  • Present open coding gaps to clinicians at the point of care.
  • Present open coding gaps to clinicians at the point of care.
  • Drive retrospective review via coder chart review workflows.
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Quality Management Solution
Enable providers to eliminate gaps in care and embrace a more patient-centered approach to improve the health plan’s Star Ratings, member retention, and enrollments.
  • Deliver a 360-degree view of patients to the provider through a unified patient record.
  • Reduce the time needed to access charts with digital chart retrievals.
  • Highlight open quality gaps via a web-based provider portal and mobile app.
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Provider Engagement Hub
Analyze provider performance and help them improve care quality with point-of-care alerts. Motivate them with incentives programs.
  • Display provider performance through a configurable dashboard.
  • Assist them in closing coding and quality gaps with point-of-care insights.
  • Drive impact by showcasing granular linkage between actions and incentives.
  • Process payments at an increased rate.
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CASE STUDY
How can MA Plans Transform Risk Adjustment and Star Ratings Performance with FHIR-enabled Data Activation Platform
A renowned healthcare services vendor assists payers, specifically Medicare Advantage health plans with complete and compliant documentation to improve Medicare Advantage member risk score
accuracy and Star Ratings.

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USERFUL RESOURCES
Whitepaper
Reduce the Cost Burden on Payers by Eliminating Coding Gaps
Medical coding may sound simple, but there are quite a few things that can and do go wrong. The sheer volume of manual documentation and…
Blog
How Payers and Providers Can Solve Data Sharing Challenges with an FHIR-enabled Data Activation Platform
By assisting providers in delivering care by giving them easy access to clinical quality care…
News
Innovaccer Launches Its Member Engagement Solution to Scale-Up Its Digital Transformation Efforts With Payers