Quality Solutions
Hospital eCQM Reporting
Monitor, measure, and improve eCQM performance down to the patient level.
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Hospital Chart-Abstraction
Streamline abstraction, reduce errors, and save time with user-friendly workflows.
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MVP Reporting
Streamlined tools to manage MVPs and boost performance.
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MIPS Reporting
Simplify MIPS reporting and monitor clinician performance.
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ACO APP Reporting
Centralized ACO reporting and clinician performance in one solution.
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Performance Tools
QualityIQ
Understand your entire health system's performance in a single view.
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ModelIQNEW
Connect quality and cost to understand financial risk and improve performance.
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Hospital Star Rating Analyzer
Turn CMS Star Ratings into clear, actionable performance insight.
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Advisory Services
Quality improvement consulting services to move beyond compliance.
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MA Stars Management NEW
Forecast Star Ratings and track performance, across your Medicare Advantage program.
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MA Drug MeasuresNEW
Improve drug measure performance with real-time insights and targeted gap closure.
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AI & Automation
PRO-PM Plus
Automate patient follow-up and documentation.
Coming soon
AI Registry Abstraction
Automate registry abstraction to reduce manual workload.
Coming soon
Agentic AI Tools
Automate member outreach and complex workflows with AI agents.
Coming soon
Community
Resource Center
Blog articles, webinars, and guides to help you master quality improvement.
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Customer Knowledge Center
Explore product updates, release notes, and insider tips from other Medisolv users to get the most from your solutions.
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Advanced Quality Improvement (AQI)
Subscription-based support, monitoring, and optimization throughout the year.
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Quality Academy
Customer-exclusive education, training, and resources for healthcare quality teams.
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Quality just became a line on your P&L: Manage CMS TEAM Financial Risk
CMS’s mandatory TEAM model ties episode spending and quality performance directly to hospital reimbursement. ModelIQ for TEAM is a financial risk management and performance analytics solution that turns monthly CMS files into a clear view of exposure, performance drivers, and projected reconciliation—before CMS issues its final settlement.
CMS TEAM Financial Risk Extends Beyond the Hospital Stay.
Episodes extend from the anchor hospitalization or outpatient procedure through 30 days after discharge or the outpatient procedure.
01
Anchor hospitalization or outpatient procedure
The episode begins with the qualifying inpatient stay or outpatient procedure at your hospital.
02
30 days after discharge or outpatient procedure
Spend continues to accrue across settings your hospital does not fully control.
03
Reconciliation
CMS compares total episode spend to your target price and applies a quality adjustment.
Final reconciliation is the verdict. ModelIQ helps you understand the result while it's still forming.
Know what's happening before reconciliation.
ModelIQ for TEAM transforms CMS files into a monthly operating view designed around four questions every TEAM leader needs answered.
How exposed are we?
See historical, YTD, and projected performance by episode category, including target vs. actual spend, variance, risk status, and projected reconciliation.
Within MODELIQ for TEAM
- Executive performance view
- CMS file workflow
Where is performance off?
Identify at-risk categories, over-target episodes, cost components and other factors creating favorable or unfavorable variance.
Within MODELIQ for TEAM
- Episode-level analysis
What’s driving the variation?
Investigate provider, procedure, readmission, post-acute, DME, outpatient, and physician follow-up patterns.
Within MODELIQ for TEAM
-
Provider & procedure analysis
-
Post-acute intelligence
-
Physician follow-up
What could change the result?
Model spend, volume, target price, and quality assumptions to understand their potential impact on estimated reconciliation.
Within MODELIQ for TEAM
-
Reconciliation projection
-
Scenario modeling
Connect quality performance to financial impact.
TEAM changes the quality conversation because performance can directly affect reimbursement. ModelIQ for TEAM brings the pieces together so teams can understand how their performance translates into estimated financial results.
Gross Projection Reconciliation
$1,250,000
Target price minus actual episode spend, YTD
Quality Adjustment
−$100,000
Applied against gross variance based on CQS performance
Est. Net Reconciliation
$1,150,000
Projected payment, before CMS's final settlement
TEAM performance isn't one team's responsibility.
ModelIQ for TEAM creates a shared operating view for finance, quality, value-based care, operations, care management and service-line teams; the groups that now share the result.
One operating view. One financial result.
Finance
Sees exposure and estimated reconciliation.
Quality
Sees how measure performance affects financial outcomes.
Operations
Sees the episodes, providers, procedures, and patterns driving variation.
Care Management
Sees what happens after discharge, including post-acute utilization, readmissions, and follow-up.
Get Started
Assess your TEAM readiness.
Schedule a quick consultation and product walkthrough to see how ModelIQ for TEAM transforms your CMS TEAM data into clear financial insights so you can understand your risk, uncover the drivers behind performance, and make smarter decisions about your financial outcomes.
Not ready for a walkthrough? Take the five-minute TEAM Readiness Assessment to identify potential gaps in your organization’s data, governance and operating strategy.
Request more information about ModelIQ for TEAM
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12171 Clarksville Pike, #168
Clarksville, MD 21029
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