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KONZA Health and The SSI Group: Revolutionizing Digital Quality Measurement

Introduction

In an era where healthcare is rapidly evolving, KONZA Health has taken a major step forward by partnering with The SSI Group to introduce the Quality Measure Optimizer Elite (QM Optimizer Elite℠). This innovative solution is aimed at reshaping digital quality measurement, reducing the burdens of reporting, and ultimately enhancing the performance of healthcare providers who are part of value-based care arrangements.

Addressing an Urgent Need

As healthcare organizations transition towards a more integrated approach, the demand for better interoperability and readiness for TEFCA (Trusted Exchange Framework and Common Agreement) has intensified. Accurate and usable data has become crucial for healthcare providers. The QM Optimizer Elite addresses this urgent need by consolidating clinical data from various providers with claims data from health plans into a singular platform. This approach offers a comprehensive view of quality performance across various patient demographics.

Dr. Katrina Parrish, Chief Medical Information Officer at The SSI Group, emphasized the significance of this innovation: "What sets our solution apart is its reliance on real clinical data that providers can trust. By meticulously validating every measure against actual clinical outcomes, we ensure that performance metrics genuinely reflect real-world scenarios."

Features and Benefits of QM Optimizer Elite

The QM Optimizer Elite is strategically designed to support a value-based care model, actively closing gaps in care, maximizing financial incentives, and enhancing collaboration between payers and providers. Its features include:

• - Support for Medicare and Commercial Payer Agreements: It seamlessly integrates with existing agreements to improve compliance and performance metrics.
• - Alignment with ACO Participation: This tool is an asset for Accountable Care Organizations, aiding them in tracking and improving their performance.
• - Built on Standards-Based Interoperability: Utilizing FHIR and CQL, the platform adheres to established standards, enhancing its reliability.
• - Rigorously Tested: Each function of the tool complies with NCQA (National Committee for Quality Assurance) specifications, ensuring accuracy and consistency in the quality data reported.

In the words of Laura McCrary, President and CEO of KONZA Health, "Providers are overwhelmed by fragmented data and complex reporting processes. QM Optimizer Elite is designed to replace that inefficiency by offering a unified, standardized approach that integrates actionable insights into everyday workflows."

Real-Time Processing

The QM Optimizer Elite stands out with its ability to provide real-time access to validated clinical and claims data. It eliminates time-consuming manual chart reviews and offers immediate visibility into high-risk patients and any gaps in care. This ensures that care teams can quickly identify patients who require immediate attention and prioritize outreach accordingly, thus enhancing outcomes before situations escalate.

Currently, the platform encompasses 20 digital quality measures with ongoing development for more. It presents a unified view of each patient’s history for every measure. For care teams, this means clear visibility into which patients have met, not met, or have been excluded from measure requirements, enabling proactive intervention.

Conclusion

The QM Optimizer Elite is more than just a tool; it is a critical development in the healthcare sector aiming to streamline quality measurement processes. By providing more accurate insights into care performance and operational efficiencies, it empowers healthcare providers to enhance their overall service quality. As KONZA Health and The SSI Group roll out this solution nationwide, the ripple effects on value-based care performance promise to be far-reaching and transformative.

For healthcare entities looking to bolster their quality measurement capabilities, the QM Optimizer Elite could very well be the game-changer they need.

Innovation for the Future

The future of healthcare is bright with tools like the QM Optimizer Elite in play. Effective partnerships and innovative solutions pave the way for enhanced patient care and streamlined processes, driving the industry towards a more efficient and effective healthcare landscape.