HealthQx ®

An analytics platform and data services solution designed for health plans that want to foster deep clinical and cost analysis through episodic claim grouping and network analysis.

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Improve Value-Based Reimbursement Program Results


Increase the speed to market of your value-based products by simplifying and reducing the complexities of your alternative payment models.


Help reduce medical costs by incentivizing providers to adopt best practices that deliver high-quality, cost-efficient care.


Manage provider adoption and engagement with data-driven, evidence-based discussions about costs and value based on the certified HC13 Prometheus Analytics platform.


Empower your data science professionals to perform their own unique analysis and reporting using the system’s self-service business intelligence capabilities.

Scale Value-Based Reimbursement Payment Models


Strategic insights

  • Access data from more than 97 HCI3-defined episodes of care. The episode of care definition library is continuously updated with additional episodes and their associated volume, cost, and care variations.
  • Improve your understanding of complex consumer populations by using our clinical methodology to identify clinically related episodes.
  • Use our episode definitions and analytics tools to modify the episode triggers, age parameters, and look-back/look-forward periods to meet your specific program needs.

Network analysis

  • Use our flexible provider attribution capabilities to connect individual physicians, practices, and facilities to specific care episodes to better understand their quality and cost performance.
  • Customize the drill-down dashboards and exportable reports to meet your unique reporting needs and to support your provider engagement discussions.

Budgets and reconciliation

  • Streamline episode budget creation by defining the average episode cost and accessing a detailed view of the associated clinical services.
  • Empower payers and providers to set quality and savings targets and to transform them into budgets.
  • Compare your providers’ performance against budgets and targets with benchmarking against top performers. Compare value-based reimbursement and fee-for-service plan performance.

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