Improve your ratings. Improve your bottom line.

Valiant Health assists the following markets to improve their ratings:

Medicare Advantage Plans

Healthcare reform ties your NCQA star rating to your reimbursement level, which means that your ability to effectively compete will be in danger if you do not maximize your plan’s HEDIS®, HOS and CAHPS measures performance. The tools provided in proActive Management can help you discover the specific plans, hospitals or clinics, providers, and members to find areas that need improvement.

Exchange Plans 

Success in the QRS program will be critical for exchange-based plans to properly reflect their quality of care in the exchange marketplace. ProActive Management will allow you to identify the providers and members contributing to your QRS scores, and learn ways to increase your ratings.

Medicaid Pay-For-Performance

Use proActive Management as the platform to drive your P4P initiatives. Trend provider performance over time and quickly understand how members and care managers are impacted by provider performance to help drive performance.

Providers, IDNs, & ACOs

You are under pressure to do a better job of tying provider compensation to care quality and cost measures. Analyze and address benefit configuration and claim coding issues, as well as any custom performance measures, to determine which strategies offer you the best outcomes – both from care quality and financial standpoints.