Clinical quality, operations, finance from the same data.
1 AI translation · Healthcare / Health PlansUniversal Overlay
You calculate and report quality measures across multiple programs: HEDIS (health plan quality), MIPS/QPP (physician quality), Hospital IQR (inpatient quality), Star Ratings (MA plans), Leapfrog, and state-specific quality reporting. Each program has specific measure specifications, different data sources (claims, clinical/EHR, hybrid chart + claims), different reporting timelines, and different audit requirements. HEDIS alone has 90+ measures across multiple domains. Measure specifications change annually. Medical record review (HEDIS hybrid measures) is labor-intensive and expensive.