Quality / HEDIS
Knowing your gaps is the easy part.
Closing them is the work.
Most organizations can pull a HEDIS gap report. Fewer have the operational infrastructure to close those gaps at the rate that moves Star ratings before the measurement window closes.
The Approach
Gap closure runs on three simultaneous tracks.
Single-track outreach programs plateau. The organizations that consistently improve Star ratings operate member outreach, provider enablement, and supplemental data retrieval in parallel, with a shared performance dashboard driving prioritization across all three.
Member Outreach
- Gap-prioritized member lists
- Multi-modal outreach sequencing (SMS, IVR, navigator)
- Scheduling workflow integration
- Member engagement analytics
Provider Enablement
- Point-of-care gap alerts in EHR
- Pre-visit planning documents
- Standing orders for preventive services
- Provider performance dashboards
Supplemental Data
- Medical record retrieval (hybrid)
- Pharmacy data integration
- Lab & specialist data pipelines
- Administrative closure workflows
Priority Measures
We focus effort where it moves Star ratings most.
Not all HEDIS measures carry equal Star rating weight. Our programs allocate outreach and intervention resources proportionally to measure weight, baseline rate, and intervention feasibility.
Where are you losing Stars?
We'll identify which measures and which operational gaps are holding your ratings back.