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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Boost Care Quality and Risk Assessment Accuracy

To succeed in today’s healthcare ecosystem, payers across different lines of business should focus on risk adjustment and care quality to drive improved health plan performance. Innovaccer’s Risk and Quality Management solution provides the right tools for healthcare payers to improve their risk assessment accuracy and quality parameters.

Point-of-care coding and quality gaps closure

Digital chart retrievals and supplemental data submission

Provider performance assessment and incentives management

Member outreach and engagement

Care
management

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.