Ranked Best in KLAS for Payer Care Management Solutions in 2022, 2023, and 2024!

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Quality Improvement Solution

Quality has become the foundation for health plan success across all lines of business, especially government programs, where Star Ratings and HEDIS® measures represent significant revenue risks and opportunities.

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Overview

Quality metrics provide documentation and validation of the care provided to individual members and populations. These metrics also inform strategy, drive performance, monitor providers and vendors, and help direct care.

How Jiva Helps With Quality Measurement

Consistently improving quality metrics requires a combination of knowing where to focus for maximum impact, efficient workflows, and real-world experience in both care and compliance.The Jiva Care Quality Navigator offers a complete integrated solution for quality improvement that includes:
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Intelligent Automation

Automated workflows leverage the Jiva Sentinel Rules Engine and our world-class clinical content resources to give teams a “next best action” orientation and the tools they need to ensure optimal interventions.

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Analytics and Reporting

The healthcare industry continues to move in the direction of increasing high-value care and eliminating wasteful, medically unnecessary services. Value-based initiatives are similarly growing both in numbers and sophistication. From simple pay-for-performance (P4P) to more intricate risk-bearing arrangements, the ability to measure, trend, report and document return on investment (ROI) is critical. Whether or not a value-based care agreement names quality measures as criteria, quality remains a fundamental component of performance.

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Clinical Intelligence

Our growing library of continuously updated clinical content and care pathways reduces variability, ensures consistent reviews, and includes high-value, member-facing educational materials.

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Experienced Advisors

Our quality program advisors are seasoned veterans with extensive real-world experience in value-based transformation. They focus on defining a customized set of core competencies and guiding process and technology implementations to achieve consistently high-quality metrics.

ZeOmega is #1 Best in KLAS for Payer Management Solutions 2022, 2023, and 2024

Additional Resources