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With HEDIS®, CAHPS®, STARS and HRSA Clinical Core measures tied directly to reimbursements, care gaps can have a serious negative impact on a health care organization’s bottom line. Every year billions of dollars in reimbursements and other payer incentives are tied to quality performance.  Quality scores can also have a big impact on a plan’s Exchange rating. As a result, many organizations are implementing formal quality improvement programs.

Citra’s Quality Measures Improvement (QMI) Solution

Citra’s QMI solution addresses disparities between what health care organizations know and what they do—and between achievableversus actual outcomes. Our multichannel outreach program is tailored to improve compliance with specific preventive and condition-specific health care services, focusing on building trust and establishing a natural dialog with each member.

Citra’s campaigns cover everything from prenatal and postpartum care to cancer screenings, medication compliance, age-related immunizations and chronic care, and everything in between. Our campaigns enable organizations to:

  • Meet quality rating goals with year-round support
  • Identify and segment at-risk members
  • Use the right communication mix to engage members
  • Remove complex compliance barriers
  • Refer physicians and schedule appointments
  • Provide clinical support at a moment’s notice

Most important, Citra’s QMI outreach solution delivers a seamless, positive experience for health plan members that allows plan management to focus on results such as cost savings, efficient resource utilization, increased member satisfaction, better access to care, and improved HEDIS, CAHPS, and STAR ratings.

Do you want to improve member engagement, remove barriers, coordinate care and maintain accurate reporting? Take the next step toward closing care gaps and improving quality. Click here to read more about Citra’s QMI solution, including two case studies that demonstrate how we delivered bottom-line benefits for one of the largest payers in the U.S., and testimonials from their members.

 

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA)

CAHPS® is a registered trademark of the Agency for Healthcare Research and Quality