Compliance & Quality
HEDIS Solutions
HEDIS gap closure, chart abstraction, medical record retrieval, and quality analytics — better scores, better outcomes, and stronger positioning with every health plan you contract with.
Quality operations
Gap closure you can watch, season you never feel
HEDIS QUALITY DASHBOARD · SAMPLE DATA
LIVEMeasure performance · gap closure YTD (ticks = 75th percentile)
WCV trailing the 75th percentile — recall campaign generated 214 outreach calls this month; 68 visits scheduled.
Season operations
1,240
care gaps closed YTD
96%
abstraction inter-rater reliability
8,400
charts retrieved this season
90+
measures supported
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What this changes for your organization
HEDIS Solutions · performance standards
measured continuouslyHEDIS measures supported across domains
90+
abstraction and retrieval capacity
Season-scale
reporting for value-based contracts
VBC-ready
Performance standards we operate to. Actual results vary by specialty, payer mix, and starting position — your free assessment establishes your own baseline.
Care gaps closed before season
Patient-level worklists and recall programs close screening and preventive gaps during the year — when they still count, for the patient and the score.
Abstraction at any scale
Certified abstractors with measure-specific QA overreads absorb measurement season entirely — your staff never touches a chart pull.
Scores you can watch move
Measure-level dashboards track gap closure and projected rates continuously — quality management becomes an operating rhythm, not an annual audit.
Stronger position with every plan
Demonstrable quality performance strengthens contract negotiations, tier placement, and incentive capture across your entire payer mix.
The stakes
The problem, in numbers
The honest diagnosis — what this challenge actually costs healthcare organizations that leave it unmanaged.
Invisible
care is uncounted care — and uncounted care scores zero
The screening happened, the vaccine was given, the follow-up occurred — but if it isn't captured, coded, and retrievable, HEDIS says it didn't happen. Scores measure documentation as much as care.
$ tiers
quality scores now decide network tiers and bonus dollars
Health plans use HEDIS-derived measures for star ratings, pay-for-performance, and value-based terms. Weak scores mean weaker contracts — regardless of clinical reality.
Season
measurement season overwhelms every in-house team
Chart requests, abstraction deadlines, and record retrieval land all at once, every year — precisely when your staff has a full schedule of patients to serve.
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HEDIS scores decide how health plans see you: they drive star ratings, pay-for-performance bonuses, network tiering, and value-based contract terms. For providers, the frustrating part is that the care usually happened — it just wasn't captured, coded, or retrievable when the plan came looking.
Our HEDIS team closes that gap in both directions. For providers: care-gap identification and outreach workflows, preventive care monitoring, and documentation patterns that make compliant care visible in claims and charts. For health plans and larger organizations: chart abstraction, medical record retrieval, and population health analytics at measurement-season scale. The result is quality scores that reflect the care you actually deliver — and reimbursement that follows.
What's included
- Care-gap identification with patient-level worklists
- HEDIS chart abstraction by certified abstractors
- Medical record retrieval and secure delivery
- Preventive care and screening recall programs
- Risk adjustment and HCC recapture support
- Quality dashboards with measure-level tracking
In the field
How organizations like yours use it
USE CASE 01
A primary care network lifted breast cancer screening 18 points
Gap identification plus a recall program ran January through October instead of a December scramble — the measure moved from below the 25th percentile to above the 75th in one measurement year.
USE CASE 02
A health plan cleared 40,000 charts in one season
Retrieval, abstraction, and QA overreads delivered at measurement-season scale with 96% inter-rater reliability — the plan's internal team focused on analysis instead of collection.
USE CASE 03
An ACO-bound group built its quality baseline in six months
Before signing value-based terms, the group needed to know its real performance. Measure-level baselining revealed strengths worth negotiating on — and two gaps worth fixing first.
Scenarios drawn from typical engagement patterns; identifying details anonymized to protect client confidentiality.
Common questions
HEDIS Solutions, answered
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