Highmark has partnered with Cotiviti, Inc. to provide access to the Provider Intelligence (PI) Tool, which is an application that can be used to understand risk, cost, and performance across a provider's True Performance patient panel.
The application facilities risk identification and risk stratification, as well as pinpointing opportunities for clinically sound, financially effective interventions. The PI Tool enables you to reduce inefficient use of resources, optimize clinical value, improve the patient experience, and measure variation in quality and performance.
The PI Tool includes your panel of True Performance attributed patients. In the application you can:
- Design and measure the impact of care management and wellness programs
- Identify, implement, and evaluate actionable patient-level clinical interventions
- Improve the operational efficiency and clinical outcomes of patient outreach and engagement
- Drive accountable care strategies and inform other alternative quality contract initiatives
- Measure and improve year-round compliance with quality-of-care guidelines
Data can be viewed in the aggregate as well as at the patient-level. Data elements available include:
- Eligibility and Patient Demographics
- Medical Claims Information
- Pharmacy Claims Information
- Risk Scores and Drivers of Risk
- Lab Results
- Health Risk Assessment Responses
For additional information on the PI tool, including access to our newsletter, you must first log in to NaviNet® and access the Resource Center that way.
Access to PI Tool
To access the PI Tool, log into NaviNet and click on Quality Blue from the left-hand menu. From the Quality Blue homepage, click on the option for Reports, and then the link for the PI Tool. If you do not have access to the Quality Blue page in NaviNet, please contact the Security Officer for your organization, or contact your Highmark Client Engagement Coordinator or Provider Account Liaison.
Last updated on 12/2/2022 9:18:20 AM