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