Healthcare Quality Measurement

Digital Quality Measurement

Improve data collection, care gap identification, and outcomes.

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Improve Care with Better Data

Turn fragmented data into insights that help improve value-based care performance.

 

Close Care Gaps Faster

Identify missing screenings, unscheduled follow-up visits, and preventive care opportunities before reporting deadlines.

 

Improve Measurement Accuracy

Automate the collection of clinical and claims data for more complete and precise quality assessment.

 

Simplify Data Sharing

Capture compliant, standardized data, with claims-to-FHIR bundles and streamline interoperable data exchange.

 

Increase Visibility

Monitor performance trends and high-risk populations with clear analytics and monthly measure reporting.

 

QM Optimizer Elite for Providers

QM Optimizer Elite for Providers streamlines care gap identification and clinical data exchange to optimize quality measurement and simplify data sharing for payer HEDIS reporting.

It collects claims and external clinical data from your preferred QHIN and delivers monthly quality measure results for proactive intervention. Providers can also monitor trends and identify high-risk patients from an intuitive analytics platform with visual insights.

 

QM Optimizer Elite for Payers

QM Optimizer Elite for Payers automates collection of complete clinical and external claims data. It connects seamlessly to your preferred QHIN to capture essential clinical records and combine them with out-of-network claims data for a fuller view of member care.

Monthly performance ratings are digitally calculated using NCQA’s CQL engine and delivered in flexible formats like JSON (FHIR®), CSV, and Excel. The solution also generates claims-to-FHIR bundles, transforming raw claims into structured, interoperable data that includes patient, provider, and service details.

 

Driving Healthcare Transformation and Innovation

SSI is at the forefront of healthcare innovation, validating digital quality measures with actual patient data, focusing on the CMS Stars and Medicaid priorities most critical to value-based care performance.

SSI leverages NCQA Digital Content Services to offer digitalized FHIR® CQL HEDIS® measures, to simplify compliance and quality measurement.

 

Let’s Lower Costs and Drive Better Outcomes

Connect with our team to get started.

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Prior Authorization

Denial Management

Claims & Clearinghouse

Eligibility

Remittance Management

Insights & Analytics

Quality Measurement

Payer Claims Operations

Prior Authorization

Denial Management

Claims & Clearinghouse

Eligibility

Remittance Management

Insights & Analytics

Quality Measurement

Payer Claims Operations

Precise Quality Measurement

Complete, accurate, and standardized digital data.

 

Proactive Care Gap Identification

Uncover improvement opportunities earlier and intervene before reporting deadlines.

Claims-to-FHIR Bundles

Transform claims into structured, interoperable data for cleaner payer submissions.

Monthly Measure Reporting

Receive recurring quality measure results with consistent visibility into performance.

Compliant Data Exchange

Capture complete clinical records through seamless QHIN connectivity and standardized formatting.

Analytics Dashboard

Track population health and high-risk patients to identify opportunities for closing care gaps through an intuitive platform.

Flexible Data Delivery

Access outputs in JSON, FHIR®, CSV, and Excel formats based on operational needs.

Built to Advance Care Quality

 

  • 01

    Capture Comprehensive Data  

    Collect internal/external claims and clinical data from connected systems across payers and providers.

     

  • 02

    Increase Relevance with Validated Measures  

    Take advantage of HEDIS measures validated with actual patient data, strengthening clinical relevance and reliability of performance measurement.

     

  • 03

    Identify Care Gaps Faster  

    Analyze trends, gaps, and benchmark performance to uncover opportunities for stronger clinical and financial outcomes.

     

  • 04

    Simplify Compliance Reporting  

    Streamline data collection for quality reporting, regulatory compliance, and value-based care performance.

     

  • 05

    Drive Continuous Improvement  

    Utilize actionable insights to enhance care delivery, improve payer-provider alignment, and achieve long-term performance objectives.

     

Improve Performance Where It Matters Most

Whether you’re a provider or payer, identify the solutions that best align with your organizational needs.

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Quality Measurement

Frequently Asked Questions

 

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