Reward Factor & QI Optimization
This analysis focuses on the measures that can have the greatest impact on these important performance improvement levers.
Understanding what's on this page using example data:
Reward Factor Improvement Opportunities: This bar graph shows measures that are projected to negatively impact the Reward Factor calculation. The measures are displayed along with their distance from the upper forecasted cut point, indicating how far they are from meeting a higher standard. 'Annual Flu Vaccine' and 'Osteo Mgmt in Women W Fracture' are the furthest behind.
QI Upside Opportunities: This bar graph identifies measures that are close to achieving the next positive QI threshold. These are areas where the plan is nearly meeting its targets and where slight improvements could lead to a positive shift in QI. 'Osteo Mgmt in Women W Fracture' and 'Annual Flu Vaccine' have the highest potential for positive change.
QI Risk Points: This bar graph shows the measures that are at risk of dropping to a lower QI category. It highlights areas where there is a need for immediate attention to prevent a decline in QI scores. 'Rating of Health Care Quality' and 'Med Adh for Cholesterol' are most at risk.
Each bar graph serves as a strategic tool for the health plan to prioritize areas for improvement. The screen aims to help plan managers understand which measures can have the most substantial impact on the plan's overall performance and where to focus efforts for quality improvement or risk mitigation. The goal is to optimize the plan's overall score by enhancing areas with the most significant potential for positive change and addressing those at risk of declining.
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