SCORE+

End-to-End HEDIS Performance Management for Health Plans and PSPs

Accelerate Gap Closure and Improve HEDIS Performance with SCORE+™ 

In a highly uncertain business environment, health plans are looking to improve their HEDIS quality scores, in order to drive operational efficiency, earn financial incentives and sustain their competitive advantage. Successful HEDIS programs require a multi-pronged approach that ties together operational, financial and quality management processes into a comprehensive analytics and performance management strategy.

SCORE+™ is a modular solution that helps you design and implement a robust, scalable HEDIS strategy through comprehensive reporting, workflow automation and NLP-based intelligence. The platform is designed to give health plans the granular visibility and transparency they need at their speed-of-business, to accelerate their journey to quality improvement.

SCORE+™ is a one-stop platform specially designed to help organizations implement a robust HEDIS program, through:

  • Holistic data integration and aggregation framework for a single view of all measures, campaigns and processes
  • Future-proof electronic clinical data acquisition strategy based on FHIR, CCDA
  • Workflow automation to drive efficiency across processes such as gap identification, chart chases and regulatory data submission
  • NLP-based modules like Chase Intelligence, Clinical Data Abstractor and HCC Risk Adjustment that minimize provider abrasion and build more efficient provider networks
  • Clinical Data Repository for quality management and other downstream use cases

SCORE+™ provides a unified approach to building and implementing a robust HEDIS strategy. It incorporates future-proof data ingestion strategy, holistic data engineering, comprehensive measure library, automated workflows, robust regulatory support and actionable analytics to improve HEDIS performance. Some of the nation’s leading health plans and PSPs rely on SCORE+™ to accelerate their value-based initiatives.

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Leveraging the SCORE+ Platform to Improve HEDIS® Compliance

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Campaign Management

One-stop, configurable, workflow-driven campaign management solution across all chart retrieval and chase execution processes.

  • Flexible campaign management through tracking of operational requirements, resource utilization/distribution or changes in campaign strategies
  • Chase logic that is configurable at a measure level to incorporate client processes/practices
  • Mobile & desktop UI for all types of campaigns including HEDIS medical records review and off-season chases
  • Ability to handle pre-HEDIS season campaigns – across supplemental data collection, provider demographic verification, scheduling, etc.
  • Out-of-the box workflow templates for standard HEDIS activities such as prospective chart reviews, medical record review/audit processes
  • Centralized clinical documentation (charts, other) for cross-functional needs, e.g. pending claims
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Chart Abstraction

Web or mobile-based clinical data abstraction module to support review & capture of medical records – increasing efficiency and removing duplication of records.

  • Configurable, data-driven screen builder to quickly add screens for additional measures
  • Ability to abstract charts on-the-move with mobile-based data capture screens
  • NLP-based automated chart abstraction for better efficiency, improved performance and effective work queue management
  • Seamless integration with a powerful measure-processing engine for near real-time impact to compliance rates
  • HIPAA compliant secure image capture
  • Ability to scan, upload and store the abstracted information along with metadata

Chase Intelligence

NLP-driven model to identify highest priority chases and maximize return on invested effort.

  • Out-of-the-box standard chase logic that is configurable to incorporate customer specific processes
  • Chase intelligence scoring algorithms to prioritize gaps and identify appropriate provider/document for closing a care gap
  • Inbuilt chase scoring and chase prioritization capability for performing focused chases with better ROI
  • Accurate routing of chases with high success rates, for varying business needs and seasonal requirements  (scheduling, gap closure, other cross-functional needs)
  • Predictive scores based on prior experience, and Data Science driven chase scoring and retrievals

Analytics and Reporting

Suite of analytics tools, dashboards and rich visualizations to improve decision making and accelerate gap-closure.

  • Out-of-the-box starter reports (e.g. Quality, HEDIS, HCC, CMS Star, Provider 360, etc.) to make the solution usable from Day-1
  • Data Science driven HEDIS/STAR optimizer to predict future cut-points, performance ratings and targeted measure portfolio
  • Additional flexibility to add custom reports or modify existing UI
  • Centralized configuration and role-based access for all reports and visualizations
  • Powerful, intuitive and easy-to-use tools for report creation and customization

Find out how SCORE+™ addresses your HEDIS quality performance needs. Get a quick demo.

SCORE+ Demo

SCORE+™ enables healthcare organizations to enhance HEDIS scores through specialized components for real-time HEDIS reporting, population health management, Chase Intelligence and chart abstraction. Our live demo sessions and platform walk-throughs give you a quick overview of key capabilities and also dive into success stories with leading health plans and PSPs.

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