SYSTEM AND METHOD FOR MONITORING AND MEASURING QUALITY PERFORMANCE OF HEALTH CARE DELIVERY AND SERVICE

摘要

A software driven health care quality management system is disclosed. This system is user friendly, allowing easy navigation through various screens that enable the user to identify drivers of Star Rating System performance. The present invention offers easy drill-down functionality from a plan level, to a provider group, individual provider, and member level to provide actionable data that can improve the quality of care and ultimately a plan's star ratings. This system addresses each of the drivers that influence overall plan revenue, by providing an enterprise business intelligence system, designed to maximize process quality measures, promote value-based purchasing, and maximize risk-adjusted revenue for such health plans and health provider organizations.