Deliver quality improvement and risk management
The optimum way to manage quality is through a holistic approach. An effective quality and risk management program provides standardized processes and proactive risk assessments to identify problems before they occur to safeguard a healthcare organization’s financial position.
Our solution provides highly qualified interim leaders that promote inter-departmental guidance and conformity to ensure cohesive performance optimization.
- align programs to collect data and support decisions that impact quality and risk
- close care gaps through cyclical analysis and periodic pattern identification
- proactive approach to identifying and preventing costly readmissions
- minimize revenue leakage caused by upcoding, inflated chargemaster, recovery audits and denials
- protect public reputation through facilitating accurate clinical quality scores
- identify and close care gaps with an emphasis on factors that have a greater impact on HEDIS scores and financial incentives
- monitor implementation of evidence-based practices, enhance the reliability and sustainability of clinical processes, and report promptly and accurately on participation in quality programs
- evaluate readiness for HIPAA compliance audits, ensure successful physician contracting, and physician compensation
- ensure strong cybersecurity defenses, system implementation, system access management, and IT general controls
- confirm strong controls are in place for third-party vendor management, case management, clinical documentation improvement, medication management and drug diversion, and nonphysician contract management