Quality Improvement

Hospitalizations account for nearly one-third of the 3 trillion dollars spent on healthcare in the United States. While the majority of hospitalizations are necessary and appropriate, a substantial number are comprised of readmissions. These readmissions are costly, potentially harmful, and often avoidable. 

Provide your clinical and quality teams with the actionable intelligence required to identify and act on opportunities for improvements around coordination and transitions between care settings. Collaborate and share critical information with your providers to help members/patients achieve better outcomes.

The Clinigence Health Quality Improvement solutions provide actionable intelligence around:

  • Readmission rates by specified periods of time, further described by facility, member/patient, diagnoses, and PCP groups
  • Avoidable ER analysis, tracking, and trending over a specified period of time, by facility, member/patient, PCP, and diagnoses
  • Complications of surgery to identify the types that most commonly occur within the population by specialty, by specialist, and down to the individual member/patient and their corresponding complications
  • Identifying procedures that are considered unnecessary and/or over-utilized when used outside of appropriate care parameters based on the Choosing Wisely criteria as determined by the American Institute of Medicine and respective specialty boards