News | May 9, 2019

CitiusTech's BI-Clinical Platform NCQA Certified For All HEDIS 2019 Measures


CitiusTech, a leading provider of healthcare technology services and solutions, has received the National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS®) certification for BI-Clinical, its healthcare business intelligence (BI) and analytics platform. BI-Clinical has been certified by NCQA for its 2019 HEDIS coverage performance measures, including administrative and hybrid measures and systematic sampling.

BI-Clinical is one of the most widely used BI and analytics platforms in the healthcare industry, with deployments at over 5,000 payer and provider locations across North America, supporting more than 70 million lives. BI-Clinical covers multiple regulatory measures (Medicaid, HEDIS, HCC, STAR), contractual, operational and quality programs and is powered by industry’s fastest rules engine that runs as often as needed to meet and exceed customer needs.

BI-Clinical powers CitiusTech’s SCORE+, an integrated platform for comprehensive quality management for health plans. SCORE+ is powered by a robust workflow engine that drives multiple workflow requirements for health plans including medical records and year-round HEDIS review.

“BI-Clinical is the only solution in the industry that is certified for both payer and provider-centric performance indicators, giving payers the flexibility to drive provider rules as advocated by 2019 NCQA adjustment rules,” says Shyam Manoj, vice president of Health Plans and Payers at CitiusTech. “BI-Clinical and SCORE+ integrate seamlessly and provide an end-to-end solution to deliver superior HEDIS / STARs performance for health plans.”

BI-Clinical offers an extensive set of configurable apps and the largest measure library in the industry, covering more than 900 key performance indicators (KPIs) around federal and commercial initiatives, including the Merit-based Incentive Payment System (MIPS), ACO, HEDIS®, Physician Quality Reporting System (PQRS), value-based payments and other contractual measures. In addition, BI-Clinical helps customers proactively engage with member populations and reduce overall per member per month (PMPM) cost.

BI-Clinical’s BIC-RMM is the industry’s first consolidated application to define, configure, test and manage all clinical, financial and operational rules across the payer organization, including custom measures, financial/operational KPIs and cohorts for member outreach. CitiusTech also recently launched BIC-Audit, the healthcare industry’s first solution for comprehensive audits of clinical measures, cohorts and rules.

“The changing payer-provider relationship is driving the need for an integrated approach to quality management,” says Jeffrey Springer, senior vice president of Healthcare Solutions at CitiusTech. “Creating and managing rules for care, risk, network, analytics, quality and regulatory programs all from the same environment enables an enterprise-wide quality approach with proven capabilities that drive improvement. BI-Clinical enables healthcare players to adapt to these changes with its up-to-date and certified technological solutions.”

About CitiusTech

CitiusTech is a provider of healthcare technology services and solutions to medical technology companies, providers, payers and life sciences organizations, with over 3,500 professionals worldwide. CitiusTech’s services and solutions include healthcare software development, healthcare interoperability, regulatory compliance, BI/analytics, consumer engagement, care coordination and population health management. CitiusTech helps customers accelerate innovation in healthcare through number of solutions and accelerators for clinical quality reporting, healthcare big data, cloud computing, mobile health and predictive analytics. With cutting-edge technology expertise, world-class service quality and a global resource base, CitiusTech consistently delivers best-in-class solutions at an unmatched cost advantage to healthcare clients worldwide.

About National Committee for Quality Assurance (NCQA)

NCQA is an independent, not-for-profit organization dedicated to assessing and reporting on the quality of managed care plans, managed behavioural healthcare organizations, preferred provider organizations, new health plans, physician organizations, credentials verification organizations, disease management programs and other health-related programs. *HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA)

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