A Real-World Application of Machine Learning AI in Value-Based Care

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AI is already proving meaningful value in healthcare, particularly at the point of care—imaging analysis, clinical decision support, and clinician productivity tools like dictation. These use cases are tangible, measurable, and improving quickly.
At qrcAnalytics, however, our focus is narrower and more pragmatic: value-based care, specifically quality measurement and HCC risk adjustment. That distinction is critical when evaluating where AI meaningfully applies.

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Building Trust in Data

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In healthcare, we talk a lot about advanced analytics, risk scoring, quality measurement, and value-based care. But the truth is simple: none of it works unless the data underneath is trustworthy.

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Are You Ready For Changes In The California IHA AMP Program?

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The California Value Based Pay for Performance (VBP4P) program is the largest alternative payment model in the United States. It predates healthcare reform by almost a decade. The program was launched in 2001 as a statewide initiative managed by the Integrated Healthcare Association (IHA) on behalf of 10 health plans. The VBP4P has been deploying quality measure sets and reporting results and the program is the longest running example of the power of the transition to value-based care.

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Four ambulatory CDI strategies to improve overall performance

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As American healthcare transitions from fee-for-service to value-based care, a growing number of healthcare systems will generate a significant portion of their revenue from risk-based payment models. In these new models, caring for more complicated patients results in higher capitation rates. While this may be good news for provider organizations — especially organizations that serve many older or chronically ill patients — there are several steps healthcare systems need to take to ensure success in these new payment models.

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Are You Ready For Changes In The California IHA AMP Program?

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The California Value Based Pay for Performance (VBP4P) program is the largest alternative payment model in the United States. It predates healthcare reform by almost a decade. The program was launched in 2001 as a statewide initiative managed by the Integrated Healthcare Association (IHA) on behalf of 10 health plans. The VBP4P has been deploying quality measure sets and reporting results and the program is the longest running example of the power of the transition to value-based care.

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qrcAnalytics Awarded MY2019 NCQA-AMP Vendor Certification

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qrcAnalytics, an analytics and service company that develops innovative technology and services for value-based healthcare organizations is pleased to announce it has met the requirements specified by the National Committee for Quality Assurance (NCQA) for Align Measure and Performance (AMP) Certification for MY2019 (Measurement Year 2019).

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COVID-19 Impacts Risk Adjustment and Telehealth

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“Medicare beneficiaries are at the greatest risk of serious illness due to COVID-19 and CMS will continue doing everything in our power to protect them” said CMS Administrator, Seema Verma. “Today we announced guidance to Medicare Advantage and Part D plans to remove barriers that could prevent or delay beneficiaries from receiving care”.

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How Technology is Responding to the Coronavirus Pandemic

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The Office of Science and Technology Policy released an article on March 16, 2020, titled a “Call to Action to the Tech Community on New Machine Readable COVID-10 Data Set”. The article is in part a call to action to the nation’s artificial intelligence community to develop new text and data mining techniques that help the community answer high-priority scientific questions related to the virus.

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COVID-19 Free Offer of Support

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In an effort to do our part in the face of the Coronavirus pandemic, qrcAnalytics is offering a free analysis report targeting COVID -19 comorbid conditions. This report will assist you in identifying your members at high risk for mortality due to the COVID-19 virus and their existing comorbid conditions.

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Two Key Changes to the CMS-HCC 2020 Model

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The Center for Medicare & Medicaid Services (CMS) contracts with Medicare Advantage Organizations (MAOs) and pays Medicare Advantage (MA) plans for managed health care based on a monthly fee per member. The payment is based on the future health care needs and the sickness burden of its members. MA is an alternative to the traditional fee-for-service Medicare.

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