ikaHEDIS, ikaPROHEDIS+ and ikaP4P
Proactive Quality Management
Meaningful quality improvement demands more than just financial
incentives to physicians. To be engaged in the improvement process,
providers need clear performance goals and the ability to track their
progress toward those goals. As next-generation pay-for-performance
(P4P) programs emerge, physicians will increasingly require real-time
or near real-time patient-level information, as well as the
communication tools that help them engage their patients.
ikaSystems integrates Web-based analytic, workflow and P4P tools to
enable proactive quality management. Providers, care managers and
members have regular access to real-time quality improvement metrics,
allowing them to take action on the best available information.
Payers can:
- Combine HEDIS reporting requirements with their own measures to
create a single, unified quality improvement program
- Improve HEDIS scores and other quality measures through early data
access
- Improve physician relations by giving them the information and tools
that improve their financial and clinical performance
- Automate and streamline the HEDIS reporting process
- Help members take a more active role in staying healthy
Enhance Impact with Meaningful Information, When and How It’s Needed
With ikaSystems quality tools, health plans can heighten collaboration
between themselves and providers and members in the quality improvement
process:
- Providers regularly receive information, such as claims, laboratory
results and clinical outcomes, that highlights individual patients who
are not receiving required care, allowing them to actively pursue
patients for routine preventive screenings, testing and chronic care
monitoring.
- Physicians and care managers can track progress toward quality
improvement goals, including HEDIS, in real time. In addition,
physicians can easily see how their performance metrics tie to their
payment, enhancing P4P results.
- Providers, care managers and patients receive notification of gaps in
care through multiple communication channels — a secure Web site,
phone, fax and email. HIPAA-compliant secure alerts when a threshold
for a clinical measure is exceeded. Repeated automated attempts are
made to contact physicians and patients, and eventually a fax report is
sent to physicians, increasing accountability.
Smooth the Flow of Information
ikaSystems combines useful information with easy-to-use tools that
increase the efficiency of any quality improvement program:
- All participants can easily share information, arrange for care
(e.g., schedule appointments) and communicate changes in care plans.
- Multi-channel communication improves participation and involvement by
providers, care managers and members.
- Standard reports meeting HEDIS and organizational requirements are
clear and easy to generate, while ad hoc reporting is intuitive for any
user.
- Workflow tools allow physicians to update completed HEDIS records
directly in ikaProQI, reducing the need for chart reviews at year end.
* Patent pending
HEDIS® is a registered trademark of the National Committee for Quality
Assurance (NCQA).
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