REVIEWS

Reviews from QMLinx® provide breadth and depth of understanding.

Each analytical report, or 'Review', can be created from scratch or from pre-defined templates. Reviews are defined by:

	Utilization Parameters: which medical services to include
	Membership Parameters: which members to include
	Drill-down Parameters or Levels: items on which health care services will be summarized
	Review Style Templates: pre-defined metrics for frequency rates, per member costs, and length of stay, and such

Different review design options are geared to different users and can be saved and shared for greater efficiency. And, once the reviews are created, they automatically update when new information becomes available. For the busy executive, that means intelligence at your fingertips.

UTILIZATION PARAMETERS

QMLinx offers a multitude of parameters.

Almost 100 parameters, and any combination thereof, can be used to isolate specific health care services. For example, do you want to review services for a specific benefit plan? PCP? DRG? Here are just a few examples of the utilization parameters available:

	Provider Groups
	Primary Care Physicians
	Medical Specialties
	Hospitals
	Benefit Plans
	Lines Of Business
	Member Medical Condition
	Diagnosis or Procedure Codes, both standard and custom
	Individual Members
	Diagnosis Related Group (if available)
	Geographic location (Street Address, City, County, State, Zip, Region)
	Time Period (Month, Quarter, Year)
	And many others...

POPULATION PARAMETERS

Define member months with QMLinx.

Population parameters are a subset of utilization parameters and allow the user to define member months. For instance, you can look at a specific population associated with:

	Provider Groups
	Primary Care Physicians
	Primary Care Medical Specialties
	Benefit Plans
	Lines Of Business
	Member Medical Condition
	Geographic location (Street Address, City, County, State, Zip, Region)
	Time Period (Month, Quarter, Year)
	And many others...

DRILL-DOWN PARAMETERS

Manage costs and quality with QMLinx drill-down capabilities.

QMLinx supplies over 50 drill-down parameters for cost and quality improvement. Many of the variables and MetaVariables™ can be customized to match the organizationÕs own nomenclature. Drill-down parameters can include:

	Provider Groups
	Primary Care Physicians
	Medical Specialties
	Hospitals
	Benefit Plans
	Lines Of Business
	Member Medical Condition
	Diagnosis Related Group (if available)
	Geographic location (Street Address, City, County, State, Zip, Region)
	Time Period (Month, Quarter, Year)
	And many others...

REVIEW STYLE TEMPLATES

QMLinx provides pre-defined metrics templates.

In addition to customized reviews, QMLinx also provides pre-defined templates. These templates can include such detail as individual encounters and member months that meet utilization criteria or can provide a high-level summarized overview. Template metrics are calculated for each service category. In total there are more than 50 metric combinations in some templates.

Some examples of the metrics' units of measure are:

	Total cost (gross, net, or fee-for-service equivalent)
	Per member per month cost
	Cost per encounter
	Cost per unit
	Encounters per thousand members per year
	Units/Bed Days per thousand members per year
	Length of stay (if applicable)

Examples of service categories (these are commonly used for Medicare populations, but are customizable for each client) include:

	Acute Inpatient
	Ambulatory
	Skilled Nursing Facility
	Ambulatory Surgery
	Pharmacy
	Radiology
	Laboratory
	Emergency Room
	Durable Medical Equipment
	Vision
	Dental
	Behavioral Health
	Home Health
	Other

PRESENTATION

QMLinx provides powerful information.

Review results can be sent directly to the printer, Microsoft Excel, Microsoft Access, or presented on screen for analysis. This is where the system is unrivaled, with powerful tools at-the-ready to assist the user:

	Sorting
	Two- and three-dimensional graphing of columns or rows: bar, pie, scatter, histograph
	Color-coded exception reporting
	Pivot tables
	Top/Bottom 'n'/'n%' restriction
	Grouping columns by Service Type (e.g. Acute Inpatient) or Metric Unit (e.g. PMPM)
	Drilling-down to next summary level
	Drilling-down directly to individual medical encounters
	Exporting to Microsoft Excel or Access
	Saving and sharing any Review or Parameter Set

QMLinx...the ultimate in business intelligence.

QMLinx® is a registered trademark of Austin Provider Solutions, Inc.