SidWin Healthcare Solutions offers a Quality Management solution that provides comprehensive Reporting and Analytics at Population, Provider, and Member level. Our solution allows a Health Plan to track performance measurement of Quality Measures across Commercial, Medicare, and Medicaid lines of business including HEDIS, STARs, and state-specific Medicaid measures.

SidWin provides robust solutions to help overcome challenges associated with HEDIS Reporting. SidWin helps payers analyze and address Stars and HEDIS measures with robust predictive analytics and a scalable processing system. We seamlessly integrate data; categorizes dashboards and reports based on health plans, overall measure and product lines and establishes a benchmark across – providers, practices, organizations, etc..

Quality measure rates calculated in the first half of the year, based on year-to-date partial data, are not fully indicative of the underlying quality compliance. SidWin provides the ability for health plans to also view compliance rates based on a rolling prior 12-month timeframe.

SidWin’s quality reporting maximizes the output in following ways: Proactive and continuous monitoring of Quality Measures including HEDIS and Medicare STARs Identification and tracking of Quality Gaps across time Comprehensive Analytics for tracking of cost and utilization trends by measure HEDIS measure tracking, Reporting, and Submission Proactive and continuous monitoring of Quality Measures including HEDIS and Medicare STARs Our quality reporting empowers health plans and care providers to seamlessly monitor the HEDIS score to make proactive interventions to meet the regulatory requirement without fail with the power of data-driven quality analytics. Measure end-to-end care effectiveness at provider-level across all the healthcare organizations located at different sites in a centralized platform. All the provider network can generate insights to be in the know of care gaps to create more engaging programs while meeting the HEDIS star rating.

Identification and tracking of Quality Gaps across time Healthcare organizations aspire to offer high-quality care to every patient but continue to fail in meeting quality compliance measures perhaps because of inadequate quality tools providing a 360- degree view of patient’ care. SidWin consolidates clinical and claims records in one location – in all likelihood – clearing up the ambiguity and motivating care management team to pinpoint reasons for lacking in HEDIS quality measures.

Comprehensive Analytics for tracking of cost and utilization trends by measure In-depth analytics enable healthcare authorities to discover underlying trends and possible interventions which were overlooked in unstructured patients records in a few clicks. Our reporting solution motivates coordinated teams to create impactful Managed Long-term Care (MLTC) programs for chronically ill patients. Our customizable solution aims to improve patient engagement that improves patient compliance which in turn exponentially increases financial outcome.

HEDIS measure tracking, Reporting, and Submission Health plans can continuously measure the performance of healthcare providers across all the five domains of HEDIS and critical dimensions of care. Moreover, our reporting solution allows health plans to compare performance on “apple-to-apple” basis. With comprehensive reporting, get full transparency into numerators, denominators and exclusions bridging the gap between patients and providers. SidWin ensures provider data submission complies with annual updates in measurement sets and enables to make state-specific submissions.