Solutions for a better tomorrow.


With access to the right data, intuitively presented, you have the expertise to shift your organization.

Forward Health Group curates your data to influence your organization — patients, clinicians, or resources. We have the ability to leverage and extend our insights with you in the era of value-based care.



Patient Leakage2020-12-14T19:14:04+00:00

Outside utilization, or “leakage,” occurs when patients attributed to a health network or living within the network’s catchment area receive care outside that system. This can have a negative impact on patient volume for the health system, increase overall costs, and interrupt coordination of patient care. At times, a single out-of-network referral can lead to a chain of high-cost interventions with questionable benefit. 

Forward Health Group helps track out-of-network utilization, providing a detailed view of referral and leakage patterns, as well as of the cost of each encounter. The Forward Health Group platform can be used to help reduce, disrupt, or prevent patient leakage, identify major cost drivers, and support a data-driven approach to optimizing resource utilization.

Rare Diseases2020-12-07T17:53:49+00:00

On average, it takes five years and consultations with seven different clinicians for an individual with a rare disease to receive a diagnosis. Even after diagnosis, effective therapies may not be available because the nature of rare diseases leads to challenges in developing treatments.

Access to accurate data about the diagnostic path, clinical course, response to therapy, and long-term outcomes is particularly critical for rare diseases because the knowledge base is often limited. Additionally, combining data from patients at different facilities can expedite the study of disease mechanisms and the development of novel therapies.

Forward Health Group provides solutions that identify, aggregate, and present relevant data from multiple sources. Health care organizations, patient advocacy groups, and researchers can benefit from increased understanding of the patient journey, improved efficiency of diagnosis, and accelerated evaluation of new treatments.

Contract Modeling2020-12-07T17:53:15+00:00

Maintaining consistent revenue integrity and evaluating the performance of payor contracts can be challenging for health care organizations, especially in the uncertainty of the current environment. Contract modeling can be used to assess the profitability of existing payor contracts and calculate expected reimbursement when negotiating terms in new payor contracts.

Historical and current data are essential for determining correct reimbursement, supporting negotiations with payors, and evaluating impact of contractual terms on your bottom line.

Forward Health Group provides accurate, complete financial and quality data so you can model contracts, understand risks, and negotiate favorable terms with multiple payors.

Value-Based Payment Models2020-12-07T17:55:21+00:00

In value-based payment models, reimbursement focuses on quality of care and patient outcomes. These models encourage optimal management of health conditions and include incentives for meeting quality and cost targets.

Payors working with a value-based care model need to evaluate the performance of provider networks, understand the average cost per member, and know the factors contributing to those costs. Providers need to be able to focus on preventive care, manage chronic conditions, and meet targets for quality measures.

Forward Health Group extracts important data elements from electronic health records and claims, presenting timely, detailed, and accurate information in a highly user-friendly format. Our interface allows quick navigation between high-level insights about populations and the specific needs of individual members and patients, facilitating efforts to improve outcomes and manage cost.

Hybrid Measures2020-12-07T17:55:43+00:00

CMS will soon require reporting of the Hybrid Hospital-Wide 30-Day Readmission measure, and other required hybrid measures may follow. These quality measures calculate results by combining clinical data with administrative data. Because EHRs record the severity of patient illness in a way claims data cannot, hybrid measures provide a more accurate assessment of hospital performance—allowing adjustment of readmission performance targets for hospitals that serve many critically ill patients. 

When implementing hybrid measures, hospitals need to submit clinical chart data recorded at specific points during treatment. But it can be difficult to find the desired element in the EHR, since many measurements and tests are repeated throughout treatment.

Forward Health Group solves this problem by mapping required data elements for different EHR systems, extracting them, and preparing them for submission.

Health Plan Member Reconciliation2020-12-07T17:56:17+00:00

There is substantial churn in the health plan market, with individuals frequently switching plans due to changes in employment, family status, eligibility through specific programs, and personal preferences. For payors, staying on top of these shifts is essential for ensuring optimal member management and accurate reimbursement to health care providers.

However, since payors and providers use different systems to identify members and patients, it can be a challenge to track member care management and handle claims with speed and precision. 

Forward Health Group gets to the core of the issue by harvesting data from the various systems to ensure accuracy of member lists and to reconcile them with patient rosters. Health plans can be confident in who their members are and where they are receiving care, while ensuring that billing is correctly attributed.


Accurate attribution of patients to providers is at the core of population health management and a key part of value-based payment models. 

But sometimes there’s a mismatch between the health plan member roster assigned to a delivery system and the patient list in the system’s EHR platform. There can also be confusion within the delivery system about which clinician is recognized by the health plan as managing care for a patient.

Forward Health Group identifies the overlaps, gaps, and disconnects between member lists and patient lists so all parties can start aligned and remain aligned.

Panel Size2020-12-07T17:57:12+00:00

Appropriate panel size helps maintain reasonable access for patients, allows physicians to build and sustain relationships with their patients, and ensures equitable workloads among clinicians. 

When determining the optimal panel size for a provider group, it’s essential to accurately assess the number of patients each clinician has and the amount of care each patient requires. For this, you need the ability to look at historical data about frequency of patient visits and whether patients have complex or chronic conditions. 

Forward Health Group lets you see this information at a glance, allowing you to easily determine which clinicians can accept new patients, to distribute work fairly, and to plan for future staffing needs.

Whole Person Care2020-10-20T03:48:54+00:00

Whole person care puts the patient at the center, addressing behavioral health and socioeconomic needs in addition to physical health. 

To deliver this type of comprehensive care, you need data from health care and service providers across the spectrum of medical professionals, behavioral health specialists, social service organizations, and community partners. 

Forward Health Group meets the evolving, complex requirements of whole person care. We assemble the needed details from all disparate data sources so you can care for the person, not just the patient.

Social Determinants of Health2020-10-20T03:48:34+00:00

Clinical measures are important. But the big drivers of health outcomes and healthcare costs originate outside the care setting. They include socioeconomic conditions and availability of housing, nutritious food, transportation, and social supportsamong others.  

Addressing social determinants of health is important for improving health and reducing longstanding disparities in outcomes. Documenting patient needs related to social determinants is a critical first step. But there is substantial variation in how data about social factors impacting health and wellness are collected, resulting in a lack of actionable information.

Forward Health Group harvests available data, identifies gaps in data, and improves workflows for better data capture and stewardship. The result? Care teams with the knowledge they need to address both the medical and social needs of their patients.

Health Equity2020-11-09T20:04:54+00:00

Health equity is achieved when everyone has the opportunity to be as healthy as possible. 

Reaching this goal will require identifying and addressing health disparities—preventable differences in burden of disease and health outcomes in socially disadvantaged populations.

Forward Health Group helps focus attention on differences in health outcomes for specific populations, using an intuitive visual display to highlight opportunities for improvement. Our platform reveals gaps in care and identifies specific needs for individual patients. This actionable information enables clinicians, patient navigators, and social workers to provide targeted interventions and connect patients with community resources to address social and financial needs.


Medicaid is a lifeline for many Americans. Health care organizations that partner with Medicaid are critical to ensuring the well-being of these individuals. But working with Medicaid can present challenges for providers, with complex reporting guidelines and eligibility requirements, as well as multiple different programs to address the diverse needs of Medicaid beneficiaries.

To collaborate successfully with Medicaid, health care organizations must be able to manage the delivery and cost of care for beneficiaries. They may also need to report on an array of quality measures depending on state or health plan requirements. 

Forward Health Group gives you the data you need in a well-designed user interface, with easy-to-understand visual displays that present an accurate picture of financial and clinical performance. We also assist in reporting quality measures and other required data to Medicaid.

Mental Health2020-12-07T18:00:08+00:00

Mental health disorders have far-reaching impacts on quality of life, risk of chronic disease, and overall wellness. They’re also among the most common causes of disability. But they remain underdiagnosed and undertreated.

One important factor is the disconnect between different parts of the health system, with separation between physical and mental health. Referrals to mental health specialists may be made, but not followed up on, in part due to the nature of mental health disorders. Counselors and social workers may never interact with the patient’s EHR to document findings and treatment recommendations. This makes it hard to track progress and evaluate the success of interventions. 

Forward Health Group’s solutions improve workflow, integrate information from multiple systems, and provide easy-to-understand data visualizations that highlight missed appointments and gaps in care, focusing attention on the needs of patients with mental health disorders.

Substance Use Disorder2020-12-07T18:01:14+00:00

Substance use disorder is a widespread condition, affecting more than 20 million Americans and resulting in more than $740 billion in healthcare costs, lost productivity, and other societal costs. 

Screening for and managing substance use disorder are important parts of routine health care. But too many of those affected fall through the cracks.

Forward Health Group can harvest EHR and claims data to identify individuals who have not been screened or have not received an appropriate intervention. We provide compelling data displays to focus attention on these patients, helping care teams ensure that screenings are completed and patients get referred for counseling or other appropriate interventions. Longitudinal data capture helps with tracking patient progress, supporting follow-up and ongoing care.

Clinician Wellbeing2020-12-07T18:01:41+00:00

The desire to help patients can be a strong motivating force for clinicians that helps balance job-related pressures. Nonetheless, stress can build up over time due to the ongoing mental and emotional demands of clinical work, ultimately affecting job satisfaction.

To support care team members, health care organizations need to identify causes of work strain and address them. While not all contributors to stress can be eliminated, many can be managed with changes in workflow and other targeted efforts.

Forward Health Group offers solutions that clarify and quantify demands on clinician time and attention, identify triggers of stress in the clinical setting, and track changes in stress over time—along with factors that influence those changes. Health care organizations can use these insights to support their workforce.

Clinician Workflow2020-11-09T20:07:21+00:00

In addition to direct patient care, clinician workload includes a substantial amount of clerical activity such as charting and responding to messages and alerts. Some of this workload could be completed by other members of the care team. 

Changing workflow to facilitate sharing of work across the care team requires detailed understanding of the current clerical burden and adjustments in managing messages and other communications. 

Forward Health Group leverages the rich data of your EHR to reveal the origin and purpose of every transaction segment, using quantitative tools to objectively measure the clerical burden on clinicians. We identify opportunities to route messages and requests to appropriate members of the care team. These changes in workflow can optimize clinician time and contribute to improved team collaboration, workflow efficiency, and patient satisfaction.

High-value Care2020-10-20T03:53:03+00:00

High-value care balances clinical benefit with costs and harms in order to improve patient outcomes. Promoting high-value care and minimizing wasted care is a critical foundation for value-based payment models.

The implementation of high-value care requires commitment to evidence-based practice, clinical measurement, and targeted improvement strategies.

Forward Health Group’s solutions provide the insights you need by finding gaps in care, identifying performance issues, and pairing patient outcomes with claims data so you can improve both the quality and cost of care.

Residency Program Support2020-10-20T03:03:55+00:00

The Accreditation Council for Graduate Medical Education (ACGME) requires that residents actively engage in clinical quality improvement as part of their learning.  

To achieve this, residents need access to quality metrics and benchmarks so they can assess their own clinical performance and track aggregate data related to their patient populations. 

Forward Health Group extracts and displays clinical outcomes for the patients of each resident, helping residents identify patient needs and formulate changes to treatment.  Residents can then track improvement in outcomes over time. Faculty and other training supervisors are able to monitor resident performance and provide guidance to ensure a successful learning experience.

Quality Measures2020-11-09T20:06:12+00:00

Clinical quality measures support efforts to improve care delivery and patient outcomes. Reporting performance on these measures is the backbone of payor incentive and risk-sharing plans.

Requirements and specifications for clinical quality measures vary among payors and incentive programs. This creates a challenge for health care providers and organizations in documenting, tracking, and reporting performance data. 

Forward Health Group captures and displays the necessary data according to whatever reporting requirements apply. Clinicians and provider organizations can monitor performance on the quality measures to ensure they will meet desired targets. Forward Health Group also supports clients in reporting required data at the end of the measurement period.

MIPS Qualified Registry2021-03-11T18:18:52+00:00

Forward Health Group is approved by the Centers for Medicare and Medicaid Services (CMS) as a Qualified Registry (QR) and as a Qualified Clinical Data Registry (QCDR) for the CMS Merit-Based Incentive Payment System (MIPS) for 2020.

Both the QR and the QCDR are approved to report all quality measures available under MIPS. The QCDR offers nine additional quality measures for reporting, designed specifically to support quality improvement/reporting in the renal/nephrology space. Clinicians and practices that use PopulationManager® as part of the reporting tracking and submission can also earn significant “bonus” points under MIPS that increase reimbursement, avoid payment penalties, and decrease staff & technology expense.

Forward Health Group’s robust Data Stewardship™ process enables practices with cumbersome, time-consuming EHR implementations to forego the next upgrade cycle and still report for the entire calendar year.

PopulationManager is the only solution on the market that maximizes data from all sources—EHRs, payor claims, practice management platforms, labs, patient captured results—and delivers clinician engagement through clinically intuitive performance measurement.

MIPS QCDR2021-12-20T22:51:14+00:00

The Renal and Vascular Outcomes Improvement Program, powered by Forward Health Group, was approved by the Centers for Medicare and Medicaid Services (CMS) as a Qualified Clinical Data Registry (QCDR) for the CMS Merit-Based Incentive Payment System (MIPS) for 2022.

Eleven Non-MIPS measures were approved for inclusion in the Quality Renal Registry QCDR. Organizations can also report on any of the 2022 MIPS Quality Measures through Forward Health Group’s QCDR or approved Qualified Registry.


View the 2022 QCDR Measures

View the 2022 QCDR Qualified Posting



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