Risk Adjustment & Quality Management

Get Help with Risk Adjustment & Quality Management from Pulse8

Pulse8, an affiliate of Veradigm is a Healthcare Analytics & Technology vendor that provides complete transparency into the efficacy of your Risk Adjustment, Quality Management, and Pharmacy Programs. Pulse8 solutions are ideal for At-Risk providers.

Pulse8’s advanced analytics and risk adjustment expertise provide invaluable support to those responsible for Risk-Adjusted Revenue, Performance-based Contracting, and Quality Management.

Pulse8 Can Help You:

  • Succeed in risk-sharing arrangements from Accountable Care Organizations (ACOs) and Patient-Centered Medical Homes (PCMH) to CMS Star Ratings and Value-Based Payments (VBP)
  • Drive risk-adjusted revenue, outcomes-based reimbursement, and quality-driven bonuses for your practice
  • Translate analytics into action to help promote patient health outcomes

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Pulse8 Products

  • Medical Management - Collabor8 + Integr8
  • Quality Management - Qualit8
  • Practice Management - Collabor8
  • Finance & Administration - Calcul8
  • Risk Adjustment - Calcul8
  • Managed Care - Calcul8 & Collabor8

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Medical Management | Collabor8 & Integr8 The user-friendly Provider Portal within Collabor8 and the EMR integration of our Integr8 technology help maximize gap closure rates while minimizing provider disruption.

  • Reduce the administrative burden of information requests by prioritizing intervention targets
  • Coordinate your efforts to close gaps in documentation, coding, and quality all at once
  • Translate analytics into meaningful action to drive positive health outcomes
  • Alerts can be delivered independently or integrated with the providers established workflows

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Quality Management | Qualit8 NCQA certified HEDIS engine that proactively identifies trends in quality performance and can strategically prioritize quality improvement initiatives.

  • Efficiently steer your HEDIS® nurses and QI staff towards closing the most meaningful quality gaps
  • Provides the flexibility to use cardinal or ordinal measures; relative or absolute determination methods; the ACA Quality Rating System (QRS), CMS Star Ratings, or State-specific Medicaid Models
  • Advanced analytics enable QM/QI managers to only target the most fruitful intervention targets

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Practice Management | Collabor8 Provider engagement solution with essential dashboards and scorecards to stay on top of clinician and patient analytics

  • Evaluate your clinicians’ clinical performance, case mix, diagnostic capture rates, and coding efficacy to identify those who might benefit from ongoing education and/or additional support staff.
  • Stay on top of your patient panel
  • Maintain your own patient profiles and analytics framework so that you can understand the risk-related data of your practice

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Risk Adjustment Analytics & Financial Reporting | Calcul8 Risk adjustment, pharmacy analytics and financial reporting solution to help you maintain a watchful eye on your practice’s risk-based contracts

  • Enables the ability to monitor how well your practice is performing on your risk-based contracts when compared to expectations.
  • Accurately helps your practice predict Medicare Advantage final year and/or mid-year risk adjustment results and ACA Commercial Transfer Payment Revenue
  • ACA Commercial Modeler can calculate the RAF Points your practice needs to reach budget and the optimal intervention level, timing, and type with which to get there.

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Risk Adjustment | Calcul8 Risk adjustment analytics and reporting solution to improve your confidence levels and predictive capabilities regarding individual patient risk factors

  • Combines advanced risk adjustment analytics with Big Data mining to produce precise and actionable risk adjustment algorithms in Managed Medicaid, ACA Commercial, and Medicare Advantage markets.
  • Patent pending Dynamic Intervention Planning helps target gap closure strategies to the right patient at the right time
  • Helps avoid pursuing low-yield interventions that may have little to no impact on risk scores

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Managed Care | Calcul8 & Collabor8 Solutions for managed care contracting teams to reduce administrative burden and drive practice efficiencies

  • Leverage Calcul8 to project the impact of the revenue and risk scores for each contract
  • Collabor8 dashboards can help uncover details about high-cost patients who may disproportionately affect your practice’s risk profile
  • Translate analytics into meaningful action to drive positive health outcomes

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Contact us for more information about managing risk and quality for your practice.

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