Clinical Benchmarks That Drive Payer Contracts and Quality Bonuses
The clinical benchmarks that matter most in value-based contracts are the same ones measured by HEDIS: A1C control (target <8% for most patients), blood pressure control (<140/90 mmHg), LDL cholesterol at goal, and tobacco cessation rates. These four metrics appear in virtually every Medicare Advantage contract and ACO quality bonus framework.
Vizier tracks every chronic disease patient against these benchmarks in real time — not at year end. Patients approaching an A1C visit who are not at goal are flagged for intensification review before the next encounter. Providers see their panel-level control rates daily, not quarterly.
Population health stratification divides your patient panel into controlled, at-risk, and uncontrolled segments for each chronic condition — enabling targeted outreach, care management enrollment, and resource allocation decisions grounded in actual clinical data.
Comprehensive Diabetes Care: Seven Measures, One Bundle
The HEDIS Comprehensive Diabetes Care (CDC) bundle is the most widely used multi-measure quality framework in the US. All seven measures are reported for Medicare Advantage and most commercial plan quality contracts. Your performance on CDC directly influences your Medicare Advantage star rating — a half-star improvement can be worth millions in quality bonus payments.
Vizier tracks every component of the CDC bundle at the patient level, identifying which patients are passing all seven measures, which are failing one or two, and which patients need the most care coordination resources to move across the performance threshold.
Medicare Advantage Star Ratings and ACO Bonus Frameworks
Star rating performance for Medicare Advantage plans is directly tied to HEDIS, CAHPS, and HOS measure results. A 4-star plan receives a 5% quality bonus on all MA payments. A 5-star plan earns an additional enrollment period and marketing advantage.
Patient Attribution Models
Understand which patients are attributed to your practice under Medicare Advantage, ACO, and commercial value-based contracts — and what quality obligations come with each attribution model.
Preventive Care Compliance Rates
Panel-wide compliance rates for every preventive service by age group, condition, and payer. Drill down to individual patients who are overdue and generate targeted outreach lists.
Care Coordination Metrics
Track care coordination touchpoints: transition of care visits, follow-up calls within 7 days of hospital discharge, specialist referral completion rates, and care plan update frequency.
Track Clinical Quality at the Patient and Population Level
See your HEDIS measure rates, chronic disease control benchmarks, and value-based contract performance — updated daily, not quarterly. Know which patients need intervention before their next lab result arrives.