Elevate performance with AI-driven quality improvement in healthcare

Everything healthcare organizations are doing to close care gaps and improve patient health outcomes relates to quality improvement. For health plan quality teams, this means meeting standards like HEDIS, reporting deadlines and improving STAR ratings, important levers of financial success that also impact reputation and influence member enrollment. In addition to HEDIS compliance requirements, quality improvement teams identify and prioritize care gaps through evidenced-based interventions to optimize condition management and improve patient outcomes year-round.

Every year, quality teams work tirelessly from January to June, focusing on HEDIS reporting. Challenges like incomplete chart coverage, high retrieval costs, and the shift to digital measures can make this process feel overwhelming, leaving little time the rest of the year to close gaps in care. Healthcare workforce shortages and tight operating margins make it challenging to staff up enough to proactively focus on patient care. Healthcare organizations need to innovate with technology to manage data and improve health outcomes – using fewer resources.

Intelligent data acquisition can accelerate medical record retrieval and process medical charts more quickly for abstractors. This gives abstraction teams more time to review records, ensure HEDIS compliance, and identify gaps in care. Intelligent data acquisition gives health plans access to greater quantities of relevant data allowing quality teams to easily identify areas for improvement, including drilling into specific HEDIS measures. In this way they can work year-round to improve HEDIS scores and close critical patient care gaps.

Artificial intelligence is a powerful tool that can assist medical coders and abstractors in accelerating quality improvement processes. Reveleer’s AI-powered technology can process both structured and unstructured clinical data – from disparate sources, and in disparate formats – to generate highly accurate insights. Not only does this technology increase organizational efficiency, it can identify care gaps with incredible accuracy to drive better outcomes for patients.

Yes, AI enhances workflow automation by automating manual tasks and reducing the errors that occur with manual processes. AI can help route documents when and where they are needed and can highlight insights to improve abstraction productivity and accuracy. AI also helps organizations better allocate resources through increased efficiency and better decision-making.

Yes, the entire Reveleer platform is compliant with CMS, HIPAA, and other regulatory bodies. We designed our platform workflows to align with CMS requirements, and our team keeps a close eye on the ever-evolving regulatory landscape to ensure processes from data acquisition to CMS submissions meets the highest regulatory standards.