Actionable Quality Metrics

Actionable Quality Metrics

HEDIS, AMP, Medicare Stars

NCQA HEDIS® Measure CertificationSM

Cozeva has successfully pursued the National Committee for Quality Assurance (NCQA) Measure CertificationSM for HEDIS® since 2013. Cozeva is currently certified to support all HEDIS® 2020 measures for real-time tracking and submissions.

NCQA AMP Measure CertificationSM 

Cozeva is also certified by NCQA to support the full California AMP (formerly known as VBP4P) measure set since 2015  – and has successfully reported AMP program performance to IHA for five years running. Today, Cozeva supports more than 75 CA physician organization reporting groups, caring for over 3 million Californians enrolled in Commercial and Medicare HMO, POS and Commercial PPO products.

Medicare Stars Part C & D Measures

Cozeva’s Quality Metrics engine includes measures from the Medicare Part C & D Star Ratings measure set, helping Health Plans and Provider Organizations track and improve their Star ratings since 2013. In one year, Cozeva has helped a MA-PD health plan go from a 3-Star to a 4.5-Star rating.

Efficient Data Retrieval

Our ACO metrics engine supports data retrieval of raw CCLF files directly from CMS as well as direct integration Electronic Health Records to construct a complete care record. 

Coordinate Efforts

Seamless data integration allows ACOs to coordinate efforts to improve health care outcomes, reduce costs, maximize savings and avoid unnecessary penalties.

Cozeva CMS Web Interface Reporting  

Cozeva supports the CMS Web Interface reporting option for ACOs, enabling you to upload and view Medical Records and Charts for your CMS-identified sample population. Track progress during submissions, identify care gaps, and leverage our metrics engine to proactively close gaps throughout the year.

CMS Approved Submission Tool 

Our Qualified Clinical Data Registry (QCDR) is approved by CMS for MIPS quality reporting for 2017 and 2018, which means we can submit directly to CMS on your behalf for any MACRA QPP programs. Cozeva’s QCDR and EHR automatically reports to CMS via Quality Payment Program Application Programming Interface (QPP API).

MIPS and ACO Quality Measures

Custom P4Q Incentives

Consolidate Separate Lines of Business

For each physician, physician organization, independent physician organization or provider network that we work with, we make measures prospective, actionable and personalized.

Payment and Scoring 

We can create scoring and payment files for your pay-for-performance programs. These files are proprietary for the health plan or health system and are configurable by our development team to meet your needs.

New Payment Model Support 

Practice performance and patient quality outcomes are now key indicators for payment. Calculate real time payments (and potential payment) and display them to your providers on their dashboard.

Actionable Insights

Use the Cozeva performance metrics management tools to track network and/or regional performance. Identify outliers by line of business, clinical measure set, health plan, etc. and proactively take steps to improve scores.

Real-Time Engine 

Cozeva’s powerful, real-time engine updates scores and metrics as they are entered, erasing the need for any third-party engines. Run custom reports and queries as per your organization’s needs. 

Cohort Builder

Cozeva’s Cohort Analyzer allows the non-technical end user to run sophisticated ad hoc reports without running complicated SQL queries. Spend more time asking the questions that matter and maximize healthcare outcome improvements.

Analytics to Drive Quality

NCQA/IHA/ Medicare Submissions

Medical Record Abstraction

Easily transform clinical data records to structured administrative data using Cozeva’s Medical Record Abstraction tools. Assign retrieval, abstraction and overreader roles dynamically. Set targets for chart retrieval and review, and track performance and progress to completion.  

Experience You Can Trust 

We have worked with major NCQA audit firms for years. Organizations using Cozeva for their reporting needs have 100% pass rates. Today, Cozeva reports for over 50 reporting groups.

Expert Support

Our dedicated quality team will provide you with Quality metrics and database SMEs support onsite and offsite during audit season and throughout the year. Cozeva clients benefit from and appreciate our responsiveness, flexibility, knowledge and superior organization and project management skills.   

*“NCQA Measure CertificationSM”, “HEDIS Certified MeasuresSM” and “VBP4P Certified MeasuresSM are service marks of the National Committee for Quality Assurance (NCQA).