AI AGENT
Identify and close HEDIS, STARS, and quality measure gaps faster with AI-driven patient identification, prioritized worklists, and automated multi-channel outreach to improve quality scores and patient outcomes.
The Care Gaps & Quality Gaps Closure Agent continuously analyzes claims, clinical data, and quality measure specifications to identify patients with open care gaps, then orchestrates targeted outreach to close those gaps before measurement deadlines.
Maps patient data against HEDIS, STARS, and custom quality measure specifications to identify open gaps in preventive screenings, chronic disease management, immunizations, and other quality domains.
Generates prioritized worklists for care teams based on gap severity, deadline proximity, patient risk, and likelihood of closure — ensuring effort is focused where it will have the greatest impact on quality scores.
Conducts multi-channel patient outreach via SMS, voice, and portal messaging to schedule appointments for gap closure. Messages are tailored to the specific gaps and services needed for each patient.
Monitors gap closure in real time as claims and clinical data flow in. Automatically updates worklists and stops outreach for gaps that have been addressed, preventing redundant patient contacts.
See how the Care Gaps & Quality Gaps Closure Agent can help your organization improve HEDIS and STARS scores through intelligent, automated gap closure.
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