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RBI Quality Insights quality reporting simplifies the identification of member quality gaps and can be configured to trigger an intervention or a targeted outreach to your members:

  • Client's own internal quality solution or,

  • 3rd Party quality software solution

The built-in flexibility to drive quality improvement independently of the quality software solution that you currently use is a major plus for your business.  We believe vendor independence is important and also gives you the capability to actively measure performance and trends, develop targeted strategies and patterns for measure improvement, and understanding projected future measure performance.

RBI Population Health Insights Quality Outcomes Reporting application provides:

  • Flexible integration with 3rd Party Quality Reporting platforms

  • Advanced dimensional modeling of the data supports virtually limitless views of all your quality data

  • Comprehensive set of pre-built reports and dashboards for quality measure reporting at the plan, provider and member levels.

  • A platform to publish and share reports and data with key business stakeholders, business partners, providers and members alike.

RBI Quality Insights provides unparalleled support for your HEDIS, State Medicaid, QRS, CMS 5-Star and URAC measure reporting needs.



HEDIS quality measures are a set of performance measures, used widely in the managed care space and elsewhere that were designed to measure health plan performance relative to national benchmarks.

The RBI Quality Insights keeps your HEDIS projects on track, providing:

  • Measure performance

  • HEDIS Project status

  • Submissions Reporting.

  • Model HEDIS data to leverage for intervention design and other internal initiatives.


RBI Quality Insights acts as a catalyst for action, that leverages unmatched predictive analytics that can trigger an intervention or outreach effort to close HEDIS Gaps. 



CMS uses a five‐star quality rating system to measure Medicare beneficiaries’ experience with their health plans and the health care system. This rating system applies to all Medicare Advantage (MA) lines of business including HMO, and PPO. It also applies to Medicare Advantage plans that cover both health services and prescription drugs (MA‐PD). ​A health plan’s rating is based on measures in five categories:  

  • Staying Healthy: Screenings, Tests and Vaccines

  • Managing Chronic (Long Term) Conditions

  • Member Experience with Health Plan

  • Member Complaints and Changes  in the Health Plan’s Performance

  • Health Plan Customer Service  

RBI Quality Insights keeps you appraised of your Star measure performance throughout the year, delivering actionable insights, leveraging our unmatched analytics that can trigger an intervention or outreach effort to close Star Gaps. 


RBI Quality Insights provides a single integrated platform for HIX data analysis and reporting. Our advanced real-time visualization and reporting of results allows you to achieve the deepest insight into the behaviors, symptoms, and treatment of target populations.


Leveraging our platform's comprehensive member profiling capability - you can achieve improved precision and lower the cost of interventions.

Healthcare Exchanges
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