QHI partners with payers and providers to increase risk-sharing and supercharge value-based performance in managed care contracts including: Medicare Advantage, Duals, Commercial, and ACO.
For 10+ years, QHI has consistently generated industry-leading managed care outcomes, including below 75 Medical Loss Ratios and 4.5+ Quality Stars.
Case examples include:
From 2010-14, for 10,000 lives in Tufts Health Plan’s Medicare Advantage HMO in Massachusetts, QHI helped reduce total medical expense by ~25% and improve Quality from 2.5 to 4.5 stars.
From 2011-14, for 35,000 lives in BCBS’s commercial HMO in Massachusetts, QHI helped reduce total medical expense by 12% and increase revenue by 3%.
In 2013, for an M-SSP ACO with 18,000 beneficiaries, QHI helped generate a record-setting savings of 4.5% and a $10.2M surplus for its providers.
In addition to partnering with private payers, QHI operates Physicians Accountable Care Solutions LLC ("PACS"), the second largest MSSP-ACO in the United States, which serves 120,000+ beneficiaries across 11 states. PACS welcomes all high performing providers who are dedicated to achieving the triple aim.