Improve cost and quality of care

Health care organizations are under increasing pressure to improve the quality of care their members receive while at the same time lowering their costs. Measuring network value can help achieve both objectives, as long as the measurement is fair and accepted by providers. PCQ Connect achieves both by providing comparisons among similar specialties and geographies, adjusting for differences in severity, and attributing results to individual providers.

Measuring provider performance with PCQ Connect enables you to:

• Improve the quality of care that providers offer members
• Increase revenue and reduce costs by providing high-quality networks
• Increase provider acceptance and reduce risk by using industry-accepted and transparent measures of provider cost and quality

Adjust for severity

PCQ Connect provides multiple methods to reflect underlying differences in the types of cases addressed and the severity of a patient’s condition, allowing you to create valid comparisons across providers.

Manage outliers

Outlier cost episodes can skew an analysis and lead to incorrect conclusions. PCQ Connect provides different methods to identify outliers. In addition, the ability to include, exclude, or set the cost to the threshold value allows you to account for and treat outlier episodes appropriately in analysis.

Define peer groups

PCQ Connect provides standard methodology for creating peer groups within the same region and specialty while offering a wide range of flexibility to meet your unique requirements. In addition, it allows each peer group to be defined by a unique collection of quality rules and episodes of care, leading to more relevant, reliable evaluations.

Attribute properly

PCQ Connect correctly attributes the right cost and quality measures to the right provider by integrating with data from two other Symmetry products: Episode Treatment Groups® and EBM Connect®. Multiple configuration parameters allow you to address your unique needs and requirements based on your populations and networks while achieving defensible results and better transparency.