Enhancing quality initiatives

In response to health reform-driven changes, health plans are developing new approaches to improve quality, track and report important dimensions of cost and service, and document member disease burden. Optum® has a comprehensive portfolio of consulting, software and services that deliver a comprehensive approach to improve and measure quality, providing a strategic approach that addresses all areas of performance that impact a plan’s success under the Five-Star Quality Rating System and drive HEDIS® reporting efficiency and compliance.

Boost Star ratings

The Quality Strategy and Operations consists of consulting, products, and services that together provide a comprehensive approach to Star ratings improvements. By adopting a strategic approach, plans can achieve success in their star ratings initiatives.

Quality Strategy and Operations combines the unmatched expertise of the Optum consulting team, with proven tools and analytics, and products and services to provide the right solution for each client.

Improve HEDIS performance

The Health Care Effectiveness Data and Information Set (HEDIS) is an industry-wide performance measurement. Using it, health plan performance can be compared effectively and uniformly, providing a way for health plans to track year-to-year performance.

Optum delivers a unique combination of expert consulting, comprehensive services, and leading technologies. These are reporting tools that provide health plans with data optimization for performance assessment and regulatory compliance reporting using industry standard metrics.

From our cloud-based HEDIS reporting system to medical record review support, audit management, and performance assessment, Optum is committed to helping clients maximize data and processes to increase HEDIS® scores – and bottom line performance.

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).