Qualidigm

What Qualidigm does

Qualidigm, Inc. is a private, mission-driven healthcare consulting company headquartered in Wethersfield, Connecticut, with offices in New Hampshire, Vermont, Rhode Island, and Maine. Founded around 1984 and operating as a Medicare Quality Improvement Organization since 1983, the firm delivers clinical practice transformation, quality improvement, patient safety, care transitions, home health and hospice consulting, long-term care advisory, utilization review, and training services to hospitals, nursing homes, home health agencies, physician practices, government agencies, and Medicare beneficiaries across New England and nationally under GSA contract 47QRAA18D0097.

The company's core proprietary technology is SMARTAUDIT, a registered-trademark web-based compliance platform that audits Medicare Conditions of Participation for home health agencies in real time and is offered on a freemium subscription basis. Qualidigm also maintains the Medicare Patient Safety Monitoring System (MPSMS) for AHRQ, runs the Project ECHO tele-mentoring program, and produces patient education video series (Lung Talk, Heart Talk). A team of Vice Presidents and Directors (including data analysis, clinical practice transformation, and home health expertise) supports delivery across these product lines.

Qualidigm generates revenue through a mix of professional services (consulting and training), managed government contracts (CMS QIN-QIO, GSA Schedule, AHRQ, CDC), recurring SMARTAUDIT subscriptions distributed both direct and via an exclusive 2015 Medline reseller agreement, and ancillary event-space rental at the Marcia K. Petrillo Center. Customer relationships include Yale New Haven Hospital, the State of Connecticut Department of Public Health, RAND Corporation, the University of Massachusetts Medical School, and the Maine Medical Association, among others.

Name

Qualidigm

Legal name

Qualidigm, Inc.

Website

https://qualidigm.org

Company type

Private

Founded year

1984

Operating status

Operating

Headcount range

51–100 employees

Short description

Qualidigm is a private New England healthcare quality improvement consultancy founded around 1984, serving hospitals, nursing homes, home health agencies, physician practices, and federal/state government clients through professional services consulting, the proprietary SMARTAUDIT compliance platform, and CMS QIN-QIO and GSA contract work.

Ownership category

akta.pro rank

Headquarters

HQ city

Wethersfield

HQ country

United States

HQ region

North America

Offices5 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Others

Revenue model

1. Healthcare Consulting Services: Professional consulting services provided to healthcare providers across all care settings including hospitals, nursing homes, home health agencies, physician practices. Services include clinical practice transformation, quality improvement, patient safety, care transitions, and regulatory compliance consulting.
2. Government Contracts: Services delivered under GSA contract to federal and state government agencies including CMS, AHRQ, CDC, and state departments of public health. Qualidigm serves as the New England QIN-QIO under CMS.
3. Training and Education Services: Educational interventions and training programs for healthcare providers including TeamSTEPPS for Long-Term Care curriculum, INTERACT training, and various continuing education programs.
4. SMARTAUDIT Software Subscription: Web-based QAPI compliance software tool with free trial available. Subscribers can automate paper processes, improve efficiency, and save time through real-time Medicare Condition of Participation compliance auditing.

Pricing tiers

Go-to-market motion3 records

Distribution channels4 records

Marketing channels6 records

Core offering

Qualidigm provides healthcare consulting services to public and private clients across all care settings, including hospitals, nursing homes, home health agencies, and physician practices. The firm's core deliverables include quality improvement, patient safety, care transitions, clinical practice transformation, regulatory compliance, and training and education services. SMARTAUDIT, a proprietary web-based compliance tool for home health agencies, complements the consulting portfolio.

Product overview

Qualidigm is a national collaborative healthcare consulting company offering a portfolio of consulting services and proprietary tools. Core offerings include SMARTAUDIT, a web-based home health compliance tool, alongside consulting services spanning Clinical Practice Transformation, Home Health & Hospice Consulting, Long Term Care & Aging Services, Care Transitions, Child Health, Data Analysis, Patient Engagement, Patient Safety, Substance Use Disorder/Opioid Use Disorder, Training and Education, and Utilization Review. The company also produces patient education resources including the Lung Talk and Heart Talk video series, and maintains significant infrastructure projects such as the Medicare Patient Safety Monitoring System (MPSMS) for AHRQ.

Differentiator

Problem solved

Functional benefit

Brands

• SMARTAUDIT: First-of-its-kind online home health compliance tool developed by Qualidigm to help home health and hospice agencies navigate regulatory requirements and assess compliance risk level in real-time

Products and services

• SMARTAUDIT Web-based compliance solution that assesses home health and hospice agency compliance risk level in real time, helping agencies standardize data, identify weaknesses, track performance, and prepare for CMS and state audits.
• Home Health & Hospice Consulting Consulting services for home health and hospice agencies covering QAPI programs, quality management, PDGM preparation, emergency preparedness, accreditation, agency start-ups, and education and training.
• Long Term Care & Aging Services Consulting services for nursing homes and long-term care providers focused on care planning, quality indicators and measures, dementia care, falls reduction, culture change, and patient safety through data analysis and evidence-based practices.
• Clinical Practice Transformation Services Consulting helping clinicians navigate evolving payment strategies, EHR optimization, Quality Payment Program / MIPS reporting, and Patient-Centered Medical Home (PCMH) and Patient-Centered Specialty Practice recognition.
• Care Transitions Engages leadership across hospitals, nursing homes, home care agencies, and physician offices to improve care delivery and reduce preventable readmissions.
• Child Health Quality improvement services covering maternal and newborn health, pediatric oral health, ADHD, developmental and autism screening, immunizations, adolescent transitions, and care coordination.
• Data Analysis Analytical services including data collection, qualitative and quantitative analysis of healthcare data, claims data aggregation, and methods for evaluating reliability and validity.
• Patient Safety Consulting providing training, education, curriculum development, data analysis, and process improvement to help healthcare providers improve safe delivery of care and reduce patient harm.
• Substance Use Disorder/Opioid Use Disorder Services Clinical improvement initiatives addressing the opioid epidemic including leadership programs, opioid prescribing strategies, MAT/MAR treatment, overdose prevention, and emergency department buprenorphine induction (RISE project).
• Project ECHO Educational platform delivering in-person meetings, virtual meetings, webinars, and learning sessions for community healthcare outcomes improvement.
• Training and Education Development and deployment of educational interventions including performance measurement, educational outreach, academic detailing, and educational meetings for healthcare providers.
• Utilization Review Admission screening and utilization review services for Medicaid, commercial fee-for-service, and managed care programs to evaluate medical necessity and appropriateness of care.
• Patient Engagement Services giving patients and families tools and knowledge to take an active role in their health, including an annual patient engagement conference and patient-focused resources.

Quantifiable outcome

• 18% reduction in opioid prescriptions, 27% reduction in doses, 16% reduction in morphine milligram equivalents in Maine through Caring for ME initiative
• +2 more outcomes

Named customers5 records

Segments6 records

Ideal customer profiles2 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature1 record

Partnerships

Eleven partnerships are on record, tiered core and minor.

• Maine Quality CountscoreStrategic or Co-development Partner · 13 December 2018Qualidigm finalized merger with Maine Quality Counts in December 2018, expanding its presence as a leading healthcare quality improvement consulting company in New England. The merger enabled Qualidigm to offer unparalleled expertise in the delivery of rural health services throughout New England to improve access to quality healthcare.
• MedlineminorChannel Partner/ Reseller/ Distributor · 21 October 2015Exclusive distribution agreement for Medline to distribute Qualidigm's SMARTAUDIT compliance tool to home health agencies.
• RAND CorporationcoreStrategic or Co-development PartnerPartnership with RAND and Abt Associates to develop and test new data elements for standardized assessment across post-acute care settings under IMPACT Act of 2014. Testing occurred in 14 markets with over 150 facilities participating.
• Abt AssociatescoreStrategic or Co-development PartnerPartnered with Abt Associates on development of standardized assessment data in post-acute settings and Long-Term Care Integrated Safety & Risk Management Program Training.
• University of Massachusetts Medical SchoolcoreStrategic or Co-development PartnerConducted study with AHRQ and UMass Medical School to improve atypical antipsychotic prescribing practices in nursing homes. Also partnered on CAUTI prevention initiatives and post-hospital discharge adverse event analysis.
• Maine Medical AssociationcoreStrategic or Co-development PartnerEstablished Caring for ME joint initiative to engage Maine health systems in addressing opioid epidemic, providing education on opioid prescribing and promoting Medication Assisted Treatment access.
• EconometricaminorStrategic or Co-development PartnerPartnered under CDC contract to develop content for comprehensive web-based infection prevention training program for skilled nursing facilities covering over 16 hours of self-directed content.
• BlueWater Emergency PartnersminorStrategic or Co-development PartnerCollaborating on RISE (Rapid Induction Starting in the ED) project to educate hospital Emergency Departments on initiating buprenorphine treatment for opioid use disorder.
• Centers for Medicare & Medicaid Services (CMS)coreOthersLong-standing partner as Medicare Quality Improvement Organization since 1983. Currently serves as part of New England QIN-QIO team and holds GSA contract for government services.
• Agency for Healthcare Research and Quality (AHRQ)coreOthersOngoing partnership for patient safety initiatives including MPSMS maintenance under AHRQ leadership since 2001.
• Centers for Disease Control and Prevention (CDC)minorOthersPartner on infection prevention training for skilled nursing facilities.

Scale indicators9 records

Recent moves7 records

Expansion highlights5 records

Market position

Weaknesses4 records

Competitive moat5 records

Customer concentration

• Xx.com/qualidigm
• YouTubeyoutube.com/user/Qualidigm
• Facebookfacebook.com/Qualidigm
• LinkedInlinkedin.com/company/53035
• Instagraminstagram.com/qualidigm_org

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles10 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Qualidigm