Interpreta’s Clinical Action is the single platform for in-year quality and risk intervention with NCQA certification in HEDIS and California IHA AMP since 2015. Clinical Action uses HEDIS, state-specific, and HCC formulations to provide a large library of quality and risk measures available in a cloud-based platform for direct user access or through easy integration with provider group and health plan ecosystems.
Clinical Action automates workflows for structured medical, lab, and pharmacy claims data and provides a robust unstructured supplemental data environment for code capture and integration with artificial intelligence and machine learning (natural language processing) solutions.
Clinical Action’s customizable population capability allows for care gap analytics from a full population health view down to the single member for in-office physician preparation. Use Clinical Action to form a population strategy and guide the insight-to-action sequence for every member in your population.
Interpreta Clinical Action Utilizes These Modules
Provides continuous population updates on open care gaps and compliance with NCQA HEDIS.
Displays a subset of HEDIS measures with performance against CMS cut points.
California IHA AMP
Provides all California IHA AMP measures for in-year monitoring and year-end submission.
HCC Risk Adjustment
Enables a quick assessment of opportunities to identify HCC eligible diagnosis for a patient.
Continuous Member Prioritization
Calculates patient priority based on quality, risk, cost, and other KPIs.