NEHI Member MediQuire was established in 2013 to align payers and providers to focus on the patient by helping them transition from fee-for-service reimbursement to value-based care. Through its advanced data analytics solutions which ensure payer-provider collaboration through effective data analytics, patients get the right care at the right time and improve their health outcomes.
To support value-based contracting, MediQuire analyzes claims and EHR data to facilitate all aspects of the contracting process through its Transpera solution. Payers and providers view the same insights on attribution, risk, quality, and cost savings opportunities via a cloud-based platform to inform data-driven contract design. Users can build value-based contracts directly within the platform, ranging from shared risk contracts and episodes-of-care to fully capitated contracts. They then have the ability to monitor contract performance with updated claims and EHR data on a monthly basis. In one analysis of a commercial payer’s membership, Transpera identified 10% of steerage and avoidable cost savings opportunities, down to the provider and patient level.
MediQuire addresses population health needs by aggregating all relevant data for a patient and surfacing actionable analytics directly within the provider workflow for clinical decision support through its Clarity solution. Clarity leverages available EHR, claims and other data to help providers close care gaps, identify missed coding opportunities, stratify patient populations, and achieve value-based contract targets. On average, quality scores improve by 30% when providers use MediQuire’s Clarity solution.