skip to Main Content

MedHOK’s 360Quality Delivers the Tools Health Plans Need to Achieve CMS 5 Star Quality Rating, Qualify for Continuous Enrollment

MedHOK’s 360Quality Delivers The Tools Health Plans Need To Achieve CMS 5 Star Quality Rating, Qualify For Continuous Enrollment

TAMPA, Fla. – August 18, 2011 – MedHOK announced today that its 360Quality® software, which seamlessly integrates patient information in real-time across the healthcare continuum, can help health plans achieve 5 Star Quality ratings and qualify for a special election period beginning in 2012.

The Center for Medicare and Medicaid Services (CMS) announced in late 2010 a special election period had been created for Medicare Advantage (MA), Medicare Advantage Prescription Drug (MAPD) and Prescription Drug Plans (PDP), allowing those with a 5 Star Quality rating to enroll beneficiaries throughout the 2012 plan year. Enrollees in plans with a Star Rating of 4.5 or less, and those in original Medicare who are eligible, may enroll in a 5 Star Medicare Advantage (MA) Plan at any point during the year.

“Healthcare is becoming increasingly quality focused and improvements in quality measures are essential to obtaining financial bonuses. Central to these improvements are technology solutions that monitor and improve scores,” said Anil Kottoor, president and CEO, MedHOK, a leading provider of cloud-based clinical and quality software to the healthcare industry. “360Quality helps health plans efficiently and accurately monitor and track the real-time data they need to achieve and maintain their 5 Star Quality rating and benefit from unlimited enrollment.”

By connecting disparate data sources, 360Quality seamlessly integrates quality measures, administrative data, performance metrics and care management data to create participant-centric, actionable information. It then shares relevant information with all participants in the healthcare continuum, giving providers a clear understanding of quality and utilization metrics, individual performance in relation to those metrics and the relationship between quality outcomes and payments.

A configurable, template-driven solution for quality and performance measures, 360Quality provides users with real-time access to HEDIS®, pay-for-performance (P4P), proprietary quality and performance measures, and patient, provider and population profiling. By providing this information in real-time providers can identify and close care gaps, thereby increasing quality scores.

Further, 360Quality comes equipped with integrated and reliable predictive analytics models that are used to generate profiles based on clinical, quality and financial data for member, provider and local populations. Risk scores are also received for every member, enabling users to make timely predictions regarding those who are at the highest risk to more accurately predict future care costs and pharmaceutical utilization.

“360Quality provides health plans with the information they need to identify and address gaps in care that may negatively affect quality scores, thus allowing them to take action before their Star Rating is impacted,” said Kottoor.

About MedHOK

Based in Tampa, Fla., MedHOK (www.medhok.com) offers cloud-based software solutions that eliminate silos and organize client-specific patient/member data into relevant and actionable information that enables physicians, ACOs, PCMHs, payers and TPAs to manage and measure care against national quality standards for optimal outcomes. Information can be shared in real time with all healthcare stakeholders. MedHOK solutions address disease management and care coordination, clinical quality and utilization review, and quality and financial measures. ICD-10 compliant and HIE-ready, MedHOK solutions are web-based, rapidly deployed and securely accessible on any device. The company’s 360Measures holds full 2011 HEDIS® certification.

Marc Ryan

Marc S. Ryan serves as MedHOK’s Chief Strategy and Compliance Officer. During his career, Marc has served a number of health plans in executive-level regulatory, compliance, business development, and operations roles. He has launched and operated plans with Medicare, Medicaid, Commercial and Exchange lines of business. Marc was the Secretary of Policy and Management and State Budget Director of Connecticut, where he oversaw all aspects of state budgeting and management. In this role, Marc created the state’s Medicaid and SCHIP managed care programs and oversaw its state employee and retiree health plans. He also created the state’s long-term care continuum program. Marc was nominated by then HHS Secretary Tommy Thompson to serve on a panel of state program experts to advise CMS on aspects of Medicare Part D implementation. He also was nominated by Florida’s Medicaid Secretary to serve on the state’s Medicaid Reform advisory panel.

Marc graduated cum laude from the Edmund A. Walsh School of Foreign Service at Georgetown University with a Bachelor of Science in Foreign Service. He received a Master of Public Administration, specializing in local government management and managed healthcare, from the University of New Haven. He was inducted into Sigma Beta Delta, a national honor society for business, management, and administration.

Back To Top