Providence Scales Value-Based Care Impact with Risk and Quality Reporting Tool

This growth was driven by the implementation of a risk and quality reporting tool by vendor Cozeva, which enabled real-time data insights and streamlined care gap closures.

Providence’s California network has expanded its value-based care (VBC) reach from one contract in 2016 to over 50 by 2024, now covering more than 650,000 patients.

This growth was driven by the implementation of a risk and quality reporting tool by vendor Cozeva, which enabled real-time data insights and streamlined care gap closures.

Michelle Best, Executive Director of Quality Improvement at Providence, said the previous system posed significant operational challenges due to manual data processing. "The administrative burden of managing numerous patient lists from various health plans, regions, and lines of business severely complicated performance monitoring and thwarted real-time patient outreach efforts," she said.

The lack of raw data and incompatible formats from health plans further delayed compliance tracking. “This challenge of not aligning with health plans created a barrier to how we were showing performance and what the health plans would report,” Best explained. Providence’s operational teams relied heavily on expensive, labor-intensive phone outreach to address care gaps.

Tool Integration Drives Equity and Efficiency

The Cozeva platform helped automate these processes, offering real-time reconciliation, external data ingestion, and EHR integration. “This technology promised to automate processes and reduce our manual workload,” Best noted. “It would allow for real-time reconciliation of health plan care gap reports, offering accurate insights into patients' care needs.”

By feeding weekly scheduling, claims, and encounter data into the tool, Providence gained visibility into contract performance across business lines. “Having the raw data for reporting would enable us to stay on top of open care gaps and develop strategies to close them sooner,” she said.

Quality Recognition and Equity Outcomes

Providence has earned over 50 quality awards in 2024 alone, including recognitions from the American Heart Association and America's Physician Groups. “These awards reflect our tangible quality performance outcomes and the positive impact on patient lives,” said Best.

The technology also supported efforts to address disparities among BIPOC populations and patients facing social barriers. “We continue to close the disparity gaps for this population and increase our compliance rates year over year,” she added.

By 2024, Cozeva’s NLP tool processed 18,000 service entries, approving 48% and saving 475 manual hours.

Stay tuned for more such updates on Digital Health News