Quality Improvement

Hospitalizations account for nearly one-third of the trillions of dollars spent on healthcare in the United States. While the majority of hospitalizations are necessary and appropriate, a substantial number are comprised of patients returning soon after recent stays. These readmissions are costly, potentially harmful and often avoidable.

Provide your clinical and quality teams with the actionable intelligence required to identify and act on opportunities for process and quality improvements around improved transitions and care coordination between care settings. Collaborate and share critical information with providers to help members/patients achieve better outcomes.

Choosing Wisely Dashboard

Choosing Wisely Dashboard

The QualMetrix Quality Improvement solutions provide actionable intelligence around:

  • Readmission rates by specified periods of time, further described by facility, member/patient, diagnoses and PCP groups
  • Avoidable ER analysis, tracking and trending over a specified period of time, by facility, member/patient, PCP and diagnoses, including cost and utilization
  • Complications to identify the types that most commonly occur within the population, down to the specialty level of an individual member/patient and their corresponding complications
  • Detailed hospital acquired conditions reporting by hospital, conditions, category of cases, and member/patient information including associated costs
  • Identifying procedures that are considered unnecessary or over-utilized when used outside of appropriate care parameters based on the Choosing Wisely criteria provided by the American Institute of Medicine and specialty boards