Member Metrics

Healthcare Organizations are focused on creating a more personalized and valuable experience for their members/patients to engage them in the management of their care with the goals of increasing satisfaction, reducing costs and improving outcomes.

To do this effectively, your organization needs a holistic view of what is happening at the member/patient level from existing medical care needs to predictive indicators of future needs.

Member Metrics Dashboard

Member Metrics Dashboard

The QualMetrix Member/Patient Metrics solution provides a holistic view of an individual member/patient to:

  • Access current member/patient cost and utilization metrics by condition
  • Determine gaps in care through clinical markers and HEDIS prevention profiles
  • Review predictive indicators of future costs and use of services
  • Drill into costs by provider, place of service, type/specialty, diagnoses, procedure and hospital revenue code
  • Identify top prescribers for each member/patient including top drug classes by cost, generic vs. brand and top drugs by cost