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To eliminate silos in their organization and create a more holistic approach to accurate risk adjustment, HEDIS® scores, and Star Ratings, many health plans have embarked on significant efforts to bring together their risk adjustment and quality improvement departments. A traditional approach unites these functions at a program level to create efficiencies and cost savings. Layering on a member-level approach built on shared clinical insights that incorporates consumer engagement can improve member experience and outcomes. Ultimately, an increased emphasis on informed decisions at the member level can deliver superior results that are more closely aligned with a health plan's overall goals.
Watch our on-demand webinar as we discuss a "next best action" analytics approach at the member level with the potential to deliver tangible impact for both risk adjustment and quality improvement. You'll gain a better understanding of:
- Aligning risk adjustment and quality improvement at a member level
- Combining datasets across functional areas to surface insights on revenue gaps and gaps in care
- Incorporating consumer engagement to drive outreach to members and providers
Senior Vice President, Analytics and Reporting
Vice President of Product Management, Risk Adjustment, Quality, and Analytics
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).