Leveraging Technology to Address Gaps in Care

Blog Posts - 15 May 2019


Closing gaps in care is critical for members/patients to obtain their best health. It is equally critical for health plans and providers to identify and address gaps in care in order to maximize quality measures such as HEDIS , ACA risk adjustment and Medicare 5-Star ratings. According to a recent report, it is estimated that there is more than $26 billion in revenue uncollected by plans and providers because they fail to address and report the closure of gaps in care.1

Effective information exchange between health plans and providers, where clinical data and insights are shared, can have a significant impact on the quality of care delivered. Both in terms of outcomes for patients and the results of quality measures that ultimately drive revenue for payers and providers alike. Having the right strategy and technical capabilities to analyze data, make it actionable and deliver recommendations at the point of care is vital to achieving an effective information exchange.

To better understand how to leverage technology to create an effective information exchange and address care gaps, read our article produced with Xtelligent Media “Closing Care Gaps to Achieve Quality Improvement, Realize Savings.”

Veradigm provides advanced solutions for health plans and payers to control costs and improve efficiency while helping to optimize health outcomes for your members. We do this by:

Partnering with health plans to develop payer messaging solutions

Veradigm is currently partnering with health plans to develop new product solutions that address their individual needs to facilitate payer-to-provider bi-directional messaging. The goal of these solutions is to integrate into the workflow of the electronic health record (EHR), decrease the need for manual operations, improve communication and positively impact the quality of care. These development efforts align with our work on the Da Vinci Project, capitalize on the project’s use cases and adhere to the relevant draft HL7®, FHIR® Implementation Guide requirements.

Streamlining data collection

Veradigm eChart Courier facilitates the sharing of clinical data and increases efficiency by automating the chart retrieval process. Once the provider opts-into the program, eChart Courier pulls data from the provider’s EHR cloud and delivers it to health plans in a secure, encrypted format to preserve HIPAA security. It was designed by Veradigm to replace manual in-office chart audits and is easy to use for both the health plan as well as the provider. It is an easy to use and implement solution to obtaining the data you need to support an effective information exchange strategy.

If you are interested in partnering with us on a solution for your health plan, contact us.


1WEDI, Report: Closing Gaps in Care through Payer-Provider Data Exchange, March 31, 2016