Care Gap Closure Services

Better care. Lower risk. Proven results.

Care Gap Closure Services is our proven program for resolving gaps in care. It will help your organization meet or exceed Pay for Performance (P4P) goals, avoid costly penalties, ensure members adhere to recommended care guidelines and enhance the quality of services provided by your plan. Using a nimble, collaborative and data-driven approach, our team of experts will work with you to identify and target pain points—then go to work addressing those gaps.

  • Through intensive outreach, our experts work closely with those identified as having one or more targeted gaps. They will:

    • Educate members about the importance of preventive care.
    • Help to schedule doctors’ appointments.
    • Call and find local pharmacies.
    • Address psychosocial barriers to care, such as lack of transportation or provider.
    • Complete follow-up calls with members, providers and pharmacies to ensure gaps are adequately resolved.
  • Your organization will see the impact of our program through ongoing monitoring and reporting activities. We also believe in a true partnership approach—where proactive collaboration ensures that we succeed as a team. And by working closely together, our program delivers a seamless and complementary experience for your members as well as your internal operations.

Learn more below…

HEDIS/Stars/QRS Support

Through clinical expertise and proven results, our forward-looking program can improve your Pay for Performance measures (encompassing HEDIS, Stars and QRS metrics)—and help lower your overall medical costs. Learn more here.

Emergency Department Education

Empower individuals to make the best choice for where to get care, reduce your costs incurred by overuse of the ER and improve your customer engagement. Learn more here.

Post-Discharge Follow-Up

Reduce costly post-discharge readmissions by ensuring patients have the knowledge, resources and motivation to adhere to self-care and follow-up instructions. Learn more here.

Notice of Pregnancy (NOP) Service

Our warm-touch service delivers health information while assessing prenatal care compliance, helping to improve birth outcomes and manage costs. Learn more here.