Quick Navigation
For health plans across the industry, the days of siloed quality and risk programs are coming to a quick end. With the continuous rise of integrated technology and innovative data analytics, payers are shifting to a more comprehensive approach in managing quality, risk, and value-based healthcare – and Inovalon is here to help health plans in every stage of this transition.
Converged Provider Enablement aligns quality and risk adjustment analytics
Our latest release of Converged Provider Enablement bridges the information gaps that have long existed between health plans, providers, and patients. Delivering the data that plans and providers need at industry-leading speed and scale, we empower provider partners to easily see gaps in care, their overall performance, and industry benchmarks. Meanwhile health plans can drive better quality outcomes, realize higher financial rewards, increase member satisfaction, and attract new members.
Converged Provider Enablement enables plans and providers to work better together at a faster and more effective rate. In fact, in a study involving a 2-million-member health plan, 84% of the value-based care quality measures demonstrated better outcomes, with a 34% average increase in compliance rates for the patients whose providers actively used the software compared with patients whose providers did not use this solution. 1
This is just one of many benefits of having a synchronized approach to quality, risk, and value-based healthcare. Additional benefits include:
More engaged provider partners
It’s hard to engage providers in value-based initiatives when they feel like it’s yet another thing to accomplish on an already lengthy to-do list. But meeting providers where they are and giving them the patient-specific insights they need to close quality and risk gaps can transform the effectiveness of your value-based programs.
Converged Provider Enablement allows you to do just that. It translates various initiatives into one single set of insights and goals, available to providers in real-time at the point of care. Providers no longer have to search for the data they need or coordinate care plans across various programs/portals. With the right analytics, all they have to do is access one report and focus on the patient in front of them.
Enhanced transparency and incentives
Converged Provider Enablement delivers better transparency into program status and performance across value-based healthcare and fee-for-service initiatives. It takes the guesswork out of identifying and addressing member gaps, benchmarking performance, and bringing various efforts together. Instead, health plans and providers are empowered with the insights they need at their fingertips to have a greater speed to impact on the members that need their attention most.
Streamlined management, with one solution
The power of Converged Provider Enablement is made possible by working in conjunction with analytics in Converged Quality, which analyzes healthcare performance on 80% of all NCQA-covered lives2 each year.
Together, these solutions deliver one provider-facing report that integrates key data in one place. The report covers standard federal and state-level initiatives and custom organization goals to help health plans improve quality outcomes, risk score accuracy, population health, and more.
Better patient outcomes
At the end of the day, value-based healthcare is all about improving patient care. When all the benefits listed above come together, it’s patients who benefit the most.
Through enhanced accuracy and efficiency in care planning, better transparency on program performance, smoother provider alignment, and better resource utilization and lowered costs, patient care can greatly improve and produce more desirable outcomes.
This goes beyond quality, risk, and value-based requirements. Effective plan-provider partnerships can transform how patient care works to better serve everyone involved in the care journey.
Advance your plan’s quality, risk, and value-based healthcare initiatives
Converged Provider Enablement is the all-in-one solution your health plan needs to manage all your key programs. Powered by the Inovalon ONE® Platform – an industry-leading suite of data-driven, cloud-based SaaS solutions that brings together national-scale connectivity, real-time primary source data access, and advanced analytics – our software helps improve patient outcomes and provider engagement while enhancing performance and eliminating the complexity of managing overlapping initiatives.
Discover why 23 of the top 25 U.S. health plans3 choose Inovalon.
Sources:
1 Inovalon internal reporting, average of customer results. June 2023.
2 Inovalon calculation based on HEDIS® MY2021 data. June 2022.
3 Top 25 health plans based on AIS List of Top U.S. Payers 2022.
Inovalon and design® and Inovalon® are trademarks of Inovalon, Inc.
