Symmetry® Provider Cost & Quality Connect (PCQ Connect)

Symmetry® Provider Cost and Quality Connect (PCQ Connect)

Symmetry® Provider Cost and Quality Connect (PCQ Connect) is software that delivers a methodology for defining peer groups of physicians so as to perform like-to-like comparisons, attributing physician responsibility for specific patients and risk adjusting for differences in patient morbidity and case mix across providers in a peer group.

Measure Provider and Provider Network Performance

PCQ Connect helps measure network value by providing comparisons among similar specialties and geographies, adjusting for differences in severity, and attributing results to individual providers. With PCQ Connect, you can:

• Improve the quality of care that providers offer members
• Increase revenue and reduce costs by providing high-quality networks
• Increase provider acceptance and reduce risk by using industry-accepted and transparent measures of provider cost and quality

Adjust for severity

PCQ Connect provides multiple methods to reflect underlying differences in the types of cases addressed and the severity of a patient’s condition, so you can create valid comparisons across providers.

Manage outliers

Outlier cost episodes can skew an analysis and lead to incorrect conclusions. PCQ Connect provides different user-adjustable methods to identify outliers. In addition, PCQ Connect provides the ability to include, exclude, or set the cost to the threshold value to account for and treat outlier episodes appropriately in analysis.

Define peer groups

PCQ Connect provides standard methodology for creating peer groups within the same region and specialty while offering a wide range of flexibility to meet your unique requirements. You can also define each peer group by a unique collection of quality rules and episodes of care, leading to more relevant, reliable evaluations.

Attribute properly

PCQ Connect correctly attributes the right cost and quality measures to the right provider by integrating data from two other Optum Symmetry products: Episode Treatment Groups® and EBM Connect®. You can address unique needs and requirements based on your populations and networks while achieving defensible results and better transparency with PCQ Connect’s multiple configuration parameters.

Service Options

Provider satisfaction and communication are important aspects of a successful program. OptumInsight experts can help you build and implement a complete, easy-to-understand, and transparent provider measurement program that accurately and fairly defines providers’ quality and value of care.

PCQ Connect is part of the Symmetry Suite of products supporting provider measurement, population and individual health care measurement, and clinical and financial trend analysis. The suite includes Episode Treatment Groups, the market’s leading episode grouper; Episode Risk Groups®, which predicts current and future health care usage for individuals and groups; EBM Connect, which measures patient and provider compliance to evidence-based guidelines; Procedure Episode Groups®, which categorizes surgical procedures to form consistent episodes of care for analysis of clinical specialists; and Pharmacy Risk Groups®, which uses prescription data and proprietary classification systems to understand and measure individual health risk.