As value-based reimbursement becomes the standard, Cotiviti’s Quality and Performance solutions allow health plans to move from simply reporting quality measures to driving the purchase, delivery, and utilization of higher value healthcare. Our solutions enable health plans to collaborate more effectively with their provider networks, with members, and with other functional teams within the plan itself. The result? Plans can successfully manage members’ clinical and financial risks, make the most of limited internal resources, and stay compliant with industry requirements and regulations.
Serving upstate New York, one large nonprofit health plan uses Cotiviti’s Quality Intelligence solution to support year-round quality improvement and improved performance in HEDIS, Star Ratings, and other quality initiatives. The results speak for themselves: in 2021, 76% of all measures related to a regulatory program—including HEDIS, Star Ratings, quality incentives, and accreditation—either improved to the next threshold or maintained their current rating, up from 68% in 2020.Read more
Cotiviti's Quality and Performance solutions enable transformative quality measurement and reporting, population health management, network management, and underwriting initiatives with a "single source of truth"—and a collaborative approach to analysis and action. Our Quality and Stars solutions enable payers to meet evolving requirements for HEDIS®, Star Ratings, state measures, and more. Our Network and Clinical Analytics solutions simplify the aggregation and organization of healthcare data to uncover member-, population-, and provider-level opportunities to mitigate clinical and financial risk. Integration between our quality improvement solutions and the Eliza® member engagement platform offers a clear path from identifying care gaps to closing them.
Greater breadth and depth
of all members reported to NCQA in 2021 were processed by Quality Intelligence
Delivering better results
medical record retrieval rate since 2017
A commitment to quality
abstraction accuracy since 2015
Take your HEDIS and Star Ratings results to the next level
Measure and report HEDIS and quality-related metrics your way
Optimize Medicare Advantage Star Ratings
Achieve >90% medical record retrieval success with a streamlined solution
Achieve >97% abstraction accuracy without hiring and training new staff
Tame your data and optimize your clinical and financial performance with one partner
Gain insights into every facet of healthcare utilization
Clearly understand and predict individual and population risk
Obtain the solid foundation you need to shift from volume to value
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).