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Member-focused analytics

POWERING AFFORDABLE CARE through a better understanding of new members’ health status and history

From addressing gaps in care to improving quality reporting (including HEDIS® and Medicare Advantage Star Ratings), Quest Diagnostics understands the challenges health plans face. We scale our member-focused, actionable-analytics offerings to meet your specific business needs.

Get ahead of risk with historical data and insights

Member Insights from Quest Healthcare Analytics Solutions combines rich laboratory data and predictive analytics to help your organization proactively identify health risks and inequities for new and current members, so you can act earlier when outreach and intervention often have the most impact.

Our innovative and flexible Member Insights can help you:

  • Understand disease history and future risk through test results and predictive analytics
  • Decrease the cost of care by identifying at-risk members sooner
  • Engage members in their care and provide the right interventions at the right time
  • Fill in gaps in care for new and existing members to improve population health
  • Identify specific program eligibility for new and existing members to inform care coordination strategies
  • Deliver overall better experiences by understanding your members’ health status and supporting them sooner, leading to higher Consumer Assessment of Healthcare Providers and Systems® (CAHPS) scores

Redefining member experiences starts with better information

Our plans provide:

  • Longitudinal patient data including up to 2 years of new member historical lab results that predates membership to your plan
  • Predictive member cost score that helps your teams support the right interventions, for the right patients, at the right time
  • Member lab data from indirect care sources (inpatient, retail locations, etc) for a more complete picture
  • Predictive patient-based inferred disease list that can help identify needed services earlier—critical in chronic kidney disease (CKD), high-risk pregnancies, diabetes, and cancer
  • Highly specific prediction for CKD to provide timely interventions that can help prevent acute exacerbations and costly care
  • Access to comprehensive data and customized reporting when you need it
  • An intuitive, searchable portal to give your team the information they need to intervene earlier

Comply more effectively with reporting requirements

Our Quality Reporting Data offering provides you with access to the member data you may need to help effectively comply with reporting requirements.

  • Dataset that captures the claims Quest has on a specific member
  • Custom reporting that lets you analyze test data by member, practice, physician, test code, or date of service across a period of time
  • Quality reporting templates that speed up the reporting process, and allow swift access to lab test data related to quality measures
  • Report retrieval that allows users to access and print a CLIA-compliant report for a member

Case study on data and disease management

Learn how Member Insights, Quest's data analytics offering, helped a top health plan be proactive about disease management.

Get the case study