Close care gaps while there's still time.
HEDIS is the national set of quality measures health plans report every year — cancer screenings, diabetes care, blood pressure control, and more. ElevateCare 360's Quality Module tracks every open measure the moment data lands, so closure happens steadily across the year instead of in a fourth-quarter scramble.
Most gaps are found after the window has narrowed.
Quality reporting consumes staff time that could go to patient care, and by the time a quarterly report lands, many of the patients who need a screening or follow-up have already gone months without one.
Late discovery
Care gaps surface long after they could have been closed. Every month of delay shrinks the time left to reach patients inside the measurement year.
Disconnected closure
Identification, outreach, orders, and result checks live in separate places. Gaps that were addressed still show as open because the proof never made it back.
Triage by ease, not impact
When every measure looks the same, teams start with the easiest gaps — not the ones that matter most for patients or for Star ratings.
Manual reporting
Large analyst teams stitch results together in spreadsheets each cycle, leaving little time to act on what the numbers show.
Continuous visibility. Year-round closure.
The Quality Module connects identification, outreach, and validation in one workflow, so care teams always know what's open, what's closing, and what needs attention next.
Step 1
Identify gaps as data arrives
Claims, the medical record, and lab results are checked against each measure continuously — not once a quarter — so an open gap appears the day the data shows it.
Step 2
Prioritize by impact
Gaps are ranked by patient need and by their weight in quality and Star ratings, so teams work on what moves outcomes first.
Step 3
Coordinate outreach
Patient lists flow straight into scheduling, reminders, and pre-visit preparation, so the gap is addressed at the next visit instead of noted and forgotten.
Step 4
Confirm the closure
Completed screenings and results are matched back to the measure automatically, so closed gaps count — and nothing is reported twice or missed.
Quality Module · Measure progress
Sample data1,286
Open gaps, ranked by impact
214
Closed in the last 30 days
Dark marker shows each measure's target rate
ElevateIQ · Ask which open measures carry the most weight for your Star ratings, then route that patient list straight into outreach.
Year-round
Gap closure
Outreach starts in January, not October
Every measure
Tracked continuously
Updated the moment new data lands
One workflow
From identification to proof
No hand-offs lost between systems
Frequently asked questions
What is a HEDIS care gap?
HEDIS (the Healthcare Effectiveness Data and Information Set) is the standard set of quality measures health plans use to report on preventive and chronic care. A care gap is a patient who qualifies for a measure — such as a cancer screening or diabetes eye exam — but has not yet received that care during the measurement year.
When should care gap outreach start?
As early as possible. Most measures follow the calendar year, so gaps identified in January have twelve months to close, while gaps found in the fall may have only weeks. Continuous tracking lets outreach begin as soon as a patient becomes eligible.
How does closing care gaps affect Star ratings?
Many HEDIS measures feed directly into Medicare Star ratings. Closing more gaps, and closing the highest-weighted ones first, helps plans and their provider partners move toward a 4+ Star rating, where additional resources for member care become available.
What data does the Quality Module use?
Claims, the medical record, lab results, and payor quality files. Combining them means a screening completed outside your network, or recorded only in a lab result, still counts toward closing the gap.
Does this replace our quality reporting process?
Yes. ElevateCare 360 becomes the place your teams track, work, and report quality measures, replacing spreadsheet reconciliation with a single, continuously updated view.