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With rising costs of care and fast-changing regulatory mandates, health plans need to invest in technology solutions that drive value-based care. They face multiple challenges around risk stratification, population health, accountable care and regulatory challenges like HEDIS® and STAR.

CitiusTech is well-positioned to help health plans drive clinical value chain excellence. CitiusTech offers a comprehensive suite of services, platforms and solutions across a wide range of payer needs. Its BI-Clinical platform for healthcare BI / analytics is NCQA certified for all HEDIS® 2020 performance measures. CitiusTech’s SCORE+ for HEDIS is an end-to-end suite for real-time HEDIS® reporting, provider collaboration and accelerated gap-closure.

CitiusTech also provides best-in-class management consulting expertise through FluidEdge Consulting (a CitiusTech Company), which focuses on strategy, operational analysis, regulatory compliance, quality programs, technical evaluation and project management. Through a strong health plan network, FluidEdge has access to a large number of health plan-focused resources with knowledge of core claims processing systems, provider data management systems and care / medical management systems.

*HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA)

FAST+ Solution

Boost FHIR adoption and data integration initiatives while complying with the CMS rule

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FHIR for HEDIS & Stars: Unanswered Questions

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Healthcare Technology Platforms

Comprehensive solution for health plans to accelerate gap closure, minimize provider abrasion and improve HEDIS/ STAR performance
Support for real-time clinical alerts and data models like UDMH, OMOP, FHIM
AI and ML based scoring algorithms for Chase Intelligence, Healthcare Data Abstraction and HCC Risk Adjustment
SCORE+ for HEDIS enables health plans to generate near realtime HEDIS reports.

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700+ pre-built KPIs across clinical, operational, financial, regulatory domains
Extensive regulatory coverage across HEDIS®, STAR, ACO, HCC, VBP, MIPS, PCMH, etc.
BIC-RMM: World's first Rules Management Module for rule definition and editing
BIC-Audit 360: Real-time audit and traceability of clinical measures, cohorts and rules

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Comprehensive healthcare data integration and management platform to drive enterprise data strategy
H-IQM: In-flight data quality monitoring through seamless integration with existing systems and 1,500+ prebuilt KPIs
HDP: Healthcare Data Pipeline is a state-of-the art solution to acquire, aggregate and transform healthcare data
Largest regulatory coverage HEDIS®, STAR, ACO, HCC, VBP, MIPS, PCMH etc.

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Health Plans & Payers: Driving Clinical Value Chain Excellence

Quality Management

With specialized quality management solutions and services, CitiusTech helps health plans track clinical quality to enhance patient outcomes and achieve regulatory compliance.

Interoperability & FHIR

CitiusTech’s FAST+ solution enables payers to lay a foundation by complying to CMS’ new interoperability rule and supporting them to achieve transformational change in their FHIR adoption journey.

Technology Modernization

With strong expertise across microservices, Cloud migration, integration, and serviceability, CitiusTech helps payers achieve technology modernization through next-gen product engineering and implementation services.

Stars Optimizer

Drive overall business transformation for Medicare Advantage plans by leveraging AI/ML driven solutions to improve CMS Star ratings

RPA for Health Plans

CitiusTech has a dedicated team of RPA experts with extensive healthcare automation experience. We help our customers accelerate their RPA inititiaves through a combination of best-in-class RPA expertise, partnerships with leading RPA products, and an extensive libraries of pre-built accelerators and frameworks.