Quality Performance Solutions

For HEDIS®*, Star, and other quality programs

Altegra Health Quality Performance Solutions offer a complete set of product and services to effectively manage quality program needs for our health plan and provider group partners. Our suite of services and solutions fully support HEDIS, Medicare Advantage Stars, and state specific programs such as CA P4P and IN OMPP, and leverage our four foundational pillars:

Experience and Expertise. Altegra Health brings decades of experience in calculating, submitting, abstracting and improving quality scores, including specialized state level measure sets. Our HEDIS engine has earned continuous NCQA recertification since 2007 without exceptions and without recertification. Each member of our clinical review team specializes in a limited number of measures, assuring accuracy and success. Our analysts are experts in quality performance and work proactively with their clients, ensuring complete and accurate rates.

Utilization and Care Analytics. Altegra Health is the only HEDIS vendor able to combine provider utilization and financial analytics with quality measures, allowing health plans to review and manage the full picture of provider performance, while simultaneously allowing providers a secure portal for self-service performance evaluation. Delivered via our secure Web-based client portal, this information empowers decision-making by both providers and employer groups to improve quality and reduce costs.

Gap Closure for Score Improvement. We offer a full suite of member engagement solutions including member education, provider office visit assistance and in-home visits to help improve quality and Star ratings. When combined with our Quality and Stars reporting, our Engagement Solutions create a complete, end-to-end solution for managing your quality programs.

Data Ingestion and Enrichment. Our data management team uses client-friendly data ingestion processes to map and convert client source data, reducing client resources to prepare extract files. Drawing from years of experience and working closely with our customers, we optimize data for use in quality performance measurement, ensuring it is accurate, complete, and properly reflects the goals of our customers. This level of attention drives optimized quality scores.

Quality Performance Solutions

Our Quality Performance solutions include:


For more information on Altegra Health, please click below to download a PDF overview document.

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