Clinical quality management Hedis/Stars

Quality ratings and the financial health of a health plan are intertwined and it’s becoming imperative for health plans and providers to bolster their quality programs with intelligence. Measures and reporting requirements become more complex every year; health plans and providers are working harder than ever to achieve the coveted five-star rating for their services which improves outcomes and revenue. It is important to gather and analyze information in a timely manner.

EXL Health can help provide a holistic solution to give payers and providers the insights they need to deliver better quality of care, drive member engagement and performance measurement.

With a modular, end-to-end solution that is a combination of products and services to drive improvements across your quality management ecosystem. The solution integrates data from different departments and platforms into a single, cohesive process that covers HEDIS, Stars, HEDIS-like, and other required measures. Combined with our robust analytics, these can be integrated into any existing workflow to drive member engagement for each measure.

Leveraging EXL’s quality management solution, health plans can:

  • Seamlessly integrate all data sources.
  • Identify high risk members for proactive outreach.
  • Close member care gaps by addressing their barriers to care and noncompliance.
  • Comply with HEDIS reporting requirements and improve Star ratings.
  • Deliver an engaging member experience.
  • Improve patient outcomes & drive compliance.

Learn how you can leverage EXL’s deep domain expertise in healthcare, data, and analytics to measure performance and drive proactive improvement in clinical quality.