skip to Main Content

Quality and Revenue Management Suite

Ensure premium quality to drive revenue realization

Quality is at the center of value-based healthcare—and members are at the center of quality. This operating model drives the need for member-centric quality programs built around regulatory guidance and requirements. We understand that healthcare organizations still based on an infrastructure system vertically oriented to a legacy claims processing fee-for-service model are struggling to make this transformation.

Quality is measured in terms of outcomes—which shifts the service focus and measures to a horizontally oriented care focus. Healthcare organizations need a powerful unified system to make this transition. MedHOK’s Quality and Revenue Management Suite enables member-centered premium quality care, compliance adherence, and quality measurement. Providing automated structured workflows fully integrated between solutions components, MedHOK enables an integrated approach to ensuring quality, compliance, and value delivery.

Solutions

  • NCQA HEDIS® (Administrative and Hybrid Measures Certification)
  • Pharmacy Quality Alliance Measures
  • Gaps in Care
  • Star Analytics
  • Pay for Performance

Featured Resources

Government Health Plans

CMS Administrator Verma: Medicaid Audits Coming

Boom! A huge bomb went off last week when Centers for Medicare and Medicaid Services…

Read More

CAG

2019 Policy Rule Means Host of Changes for Medicare Plans

While plans look predominantly at the annual Call Letter for guidance on policy changes, this…

Read More
Back To Top