Integrated Quality Measurement, Reporting & Improvement Solution

Integrated Quality Measurement, Reporting & Improvement Solution

Leading the market with advanced analytics and data-driven intervention capabilities, Inovalon’s Quality Measurement, Reporting and Improvement Solution, powered by the Inovalon ONE® Platform, provides precise accreditation measurement, value-based outcomes and accelerated reporting with up to 15x faster processing speeds to support payers, providers, pharma/life sciences, specialty pharmacy, and device manufactures, while improving quality, utilization and financial performance.

The need to deliver and improve value is impacting all segments of healthcare. Organizations across the healthcare ecosystem are facing increasing pressure to improve clinical and quality outcomes, utilization efficiency and financial performance. In this environment, the ability to extract, analyze and manage enormous amounts of disparate data is critical in order to provide actionable insights for members. With a flexible approach, Inovalon’s integrated quality solution helps healthcare organizations meet this challenge head on, providing the innovative big data technologies and cloud-based data-driven strategies needed to improve care quality and coordination—identifying care gaps and ensuring the right intervention is applied for the right patient, in the right venue, at the right time—and comply with federal and state-based regulatory requirements for the measurement and reporting of clinical and quality outcomes.

Quality Solution Core Capabilities

Certified Measurement and Reporting
Inovalon provides 65% of the nation’s clinical and quality outcomes measurement analytics. As the quality leader in the industry, Inovalon continuously analyzes and measures quality performance throughout the year and consistently provides valuable insights on quality measures. In addition to its comprehensive certified measure catalogs supporting the reporting requirements of federal, state and other accrediting bodies, Inovalon offers healthcare organizations the flexibility to develop and customize measures, and creates custom reports presenting historical and current views including membership, quality, revenue and cost utilization.

Data-Driven Analysis and Planning
Advanced algorithms applied to Inovalon datasets identify care gap influences, while enabling the unique forecasting of patient compliance probabilities with demographics and compliance. Predictive and comparative analytics provide insights into quality ratings, industry benchmarks and intra-year cut-points predictions, while comparative analytics continually evaluate quality measure performance against regional and national benchmarks. Analyses identify gaps in care and are used to inform and develop patient-level roadmaps that guide coordinated, targeted intervention activities.

Highly-Targeted Intervention Execution
Inovalon improves quality rating performance and achieves and retains accreditation through a combination of gap-closing intervention and engagement strategies leveraging targeted, patient-specific, multi-channel communications (e.g. letter, email, SMS, etc.), and multi-venue care options including physician offices, patient homes and retail clinics. Gap closure is further supported by Inovalon’s data-driven solutions, including:

Strategic Advisory Services
Inovalon and Avalere Health data-driven advisory and consulting services provide insight proven to increase measure performance, efficiency, effectiveness and value for more than 200 organizations. Ongoing system analysis and monitoring by industry experts help uncover issues impacting performance and maximize organizational efficiency and effectiveness.

Underlying Technology Foundation

With a modular approach, Inovalon’s integrated quality solution provides the flexibility needed to deliver differentiated value while scaling each implementation to a healthcare organization’s unique needs. Inovalon’s advanced technology architecture delivers unparalleled processing times that enable accelerated decision making and speed-to-impact to inform quality analysis and improvement programs – achieving dramatic improvements in data aggregation simplicity and greater than 15 times processing speed capabilities as compared to the other available industry-leading technologies.

From data aggregation to analytically-informed quality improvement, Inovalon delivers meaningful impact and value with:

Integrated Modules
Cloud-based proprietary modules enable real-time, big data integration at accelerated processing speeds with exceptional security measures — over 1,100 data integrity checks and continuous monitoring.

Unparalleled Datasets
Proprietary data superset (MORE2 Registry®) enables multi-year analysis of historical performance patterns creating baseline assessments, profiles and insights on measure performance.

Data Visualization & Reporting
Dashboards and reports provide insights to track performance and drive measurable outcomes to support decision making on future strategies from an executive view to a tactical level.

Benefits of Inovalon's Integrated Quality Solution

Inovalon combines advanced cloud-based data analytics and data-driven intervention strategies to achieve meaningful impact in clinical and quality outcomes, utilization, and financial performance. Results for healthcare organizations include:

Improved quality ratings (e.g., CMS 5-Star and QRS)
Deeper insights on quality ratings and benchmarks
Improved care quality and member retention
Better utilization efficiency and care coordination
Improved financial performance
Enterprise-level business intelligence to support decision making
Regulatory compliance
Integrated data management