Quality Intelligence
Find out where the contract is going while you can still change it.
Value-based contract performance moves every month of the performance year. Most organizations get a reliable read on it once — at reconciliation, when there is nothing left to do about it.
Works from quality measure and utilisation extracts you already produce for submission and contract reporting.
The problem
A performance year is twelve months long. Most organizations get one look at it.
The mechanics of a risk contract are unforgiving in a specific way: the money is determined by a full year of performance, but the signal arrives late and incomplete. Payer reports lag. Claims run out over months. Attribution shifts underneath you. By the time a settlement statement is definitive, the year is closed.
So most organizations manage the contract on a mixture of partial payer feeds, internal quality reporting on a different cadence, and an experienced person's judgement about how it feels compared to last year. That works until a measure drifts in one cohort, or utilisation moves in one setting, and nobody sees it for two quarters.
The teams that perform well on risk contracts are not usually the ones with better reconciliation analysis. They are the ones who knew in month four that a measure was heading the wrong way, while there was still time to run an intervention that changed the outcome.
- Contract performance is genuinely understood only after the payer settles
- Quality measure position is reviewed on a submission cycle, not a management cycle
- Attributed population changes and nobody reconciles what that did to the denominators
- Utilisation trends are visible in claims that arrive too late to influence
- Care management capacity is allocated by referral volume rather than by contract impact
- The organization cannot say which single intervention would most improve this year's result
Capabilities
What Vizier surfaces in value-based care data
Vizier evaluates contract-relevant performance continuously and raises what moved, so decisions happen during the performance year rather than after it.
Quality measure drift
Measures moving away from threshold within specific cohorts or sites, surfaced while the performance year still has enough time left to respond.
Utilisation movement
Changes in admissions, readmissions, ED use and post-acute placement for the attributed population, caught as the pattern develops.
Attribution change
When the attributed population shifts materially, and what that does to denominators, benchmarks and the comparability of your own trend.
Cost trajectory
Where spend is diverging from the benchmark or from prior-year pattern, narrowed to the cohorts and settings driving it.
Intervention prioritization
Which cohorts carry enough combined measure weight and gap size to be worth limited care management capacity this quarter.
Quantified exposure
What a drift is worth against the contract where the evidence supports an estimate, so the conversation is about money rather than percentages.
What a finding looks like
This is the finding that pays for the platform. Two measures, three practices, five months left — and a specific cause: the attributed population grew and outreach capacity did not.
At reconciliation this would have been a variance to explain. In month seven it is a staffing decision with a quantified payoff.
Two quality measures are drifting below threshold with five months of the performance year left.
- Both measures sat above threshold at the start of the year and have declined steadily since Q2.
- Three practices account for most of the movement; the remainder of the network is stable.
- The affected denominators grew after an attribution change in Q2, diluting numerator performance.
- Gap closure volume has not increased to match the larger denominators.
Review outreach capacity at the three affected practices against the post-attribution denominator size, starting with the two measures nearest threshold.
The reporting gap
Why contract reporting arrives too late to act on
Nothing about this is anyone's fault. The reporting cadence is set by claims runout and payer processes, and neither is under your control.
- Payer performance reports lag by design, and lag most for the measures that depend on claims.
- Internal quality reporting runs on a submission cycle, which is not a management cycle.
- Attribution changes silently, and denominators move with it.
- Aggregate network performance conceals practice-level divergence.
- Cost and quality data live in separate reports, so trade-offs are argued rather than evidenced.
- By reconciliation the analysis is forensic — accurate, and useless for changing the result.
What this replaces
This replaces waiting for the payer to tell you
Most value-based care teams already build an internal view of contract performance, usually in a spreadsheet, usually maintained by one person who understands the mechanics. It is rebuilt each year, it lags, and it becomes a single point of failure.
The alternative most organizations consider is a consulting engagement to model contract performance — which produces a good answer, once, at a point in time, for a fee.
Vizier maintains that view continuously from data you already extract, and raises movement as it happens.
- The contract performance spreadsheet one person maintains and everyone depends on
- Annual or mid-year consulting engagements to model where the contract is heading
- Manual reconciliation of attribution changes against measure denominators
- Waiting on lagged payer reports to confirm what your team already suspected
- Allocating care management capacity by referral volume because impact ranking was not available
Who this is for
One contract. Three decisions that have to happen before year end.
Population Health / Quality
Which measures are drifting, and where does intervention change the contract result?
- Care gaps and rising-risk cohorts prioritized by impact
- Measure performance variation against peer benchmarks
- Programs ranked by what the evidence says will actually move outcomes
CFO / Finance
What is our realistic position on this contract, and what is the exposure if nothing changes?
- Revenue leakage surfaced with the exposure quantified
- Reimbursement and payer performance movement, early
- Financial impact ranked so the biggest number gets attention first
COO / Operations
Where do we put care management capacity to affect the outcome this year?
- Throughput and patient flow constraints identified by location and service line
- Performance variability between sites made visible rather than averaged away
- Operational deterioration flagged while it is still a trend, not a crisis
Getting your data in
Start from what you already submit.
Value-based care is unusually well served by existing extracts, because contract reporting and quality submission already require most of the data.
- Quality measure extracts already produced for submission.
- Payer performance and attribution files as they arrive.
- Claims or encounter data for utilisation and cost trajectory.
01
Upload
CSV, Excel, or an export you already produce. Drop it in and Vizier reads it. This is where most organizations start, and it is enough to see real findings against your own numbers.
02
Scheduled
A recurring feed over secure transfer, on whatever cadence your team already runs. No one re-uploads anything by hand, and nothing about your source systems has to change.
03
Connected
Direct read-only connectivity to your EHR or source systems via FHIR R4, HL7 v2, or vendor APIs. Vizier reads; it never writes back.
Connect your EHR when you’re ready. See supported systems.
Security and governance
The page your CIO will ask for
Security questions get answered before a demo, not after procurement stalls.
HIPAA compliant
PHI handled under HIPAA Security Rule safeguards.
BAA included
Executed within one business day, on every plan.
Encrypted throughout
AES-256 at rest, TLS 1.3 in transit.
Read-only access
Vizier reads from source systems. It never writes back.
Role-based access control
Scoped permissions with SSO available.
Audit logging
Every query logged with account, timestamp and result size.
Tenant isolation
Your data is segregated from every other customer's.
SOC 2 Type II audit underway
Not yet certified. Report available under NDA on completion.
FAQ
Questions buyers ask
Which contract types does this cover?
The mechanics generalise across shared savings, downside risk, Medicare Advantage and commercial value-based arrangements, because the underlying question is the same in all of them: which measures and cohorts are moving, what is that worth against the contract, and is there still time to act. Programme-specific attribution modelling is not our depth — if that is your central requirement, a specialist ACO platform may serve you better and we would say so.
Do you need payer files to be useful?
No, though they improve the picture. Clinical quality data alone will surface measure drift, cohort concentration and site variation, which is where most of the actionable findings are. Payer files add attribution accuracy and cost trajectory. Most organizations start with what they already extract internally.
How do you estimate contract exposure?
From the relationship between measure position, threshold and the contract terms as your organization has described them, applied to the affected population. Where the evidence does not support a reliable number, Vizier does not produce one — a confident figure built on thin evidence is worse than no figure, particularly in a board paper.
We already have a population health platform. Does this overlap?
Partly, and it is worth being deliberate about the boundary. Population health platforms generally manage the work — stratification, lists, care management workflow. The gap they tend to leave is continuous detection of movement and its contract consequence. If your platform produces good lists and your team still discovers drift at the mid-year review, that is the overlap worth closing.
Can this tell us which intervention to run?
It will tell you which cohorts carry the most combined measure weight and gap volume, and what the movement is worth, which is the input to that decision. The clinical judgement about what intervention suits a cohort stays with your team — we surface where the leverage is, not what care to deliver.
Related reading
See where your contract is actually heading.
Bring a quality measure extract. Thirty minutes, and you will know whether anything is drifting that you had not spotted.
Start with the data you already have. Connect your EHR when you’re ready.