Most plans learn about open gaps from a file that’s weeks old — and chase them by phone until December.
A half-star drop can cost a mid-size plan tens of millions in quality bonus dollars. Meanwhile, the measurement itself is changing: NCQA is phasing out hybrid chart review, so gaps closed in the exam room must reach you as electronic clinical data, or they don’t count. Retrospective dashboards tell you what you missed. StarsIQ closes the gaps while there’s still time.
Built for the Stars team
Denominators, numerators, and exclusions recomputed at least weekly on claims and clinical data, aligned to NCQA digital measure specifications (CQL on FHIR). No waiting for a vendor file.
Every member, every measure, every gap, tracked from open to outreach to scheduled to closed, with the measurement-year deadline and Star weight attached.
The Quality Agent sends each gap to the right CareInsight agent: Outreach books the screening, Omni-Channel Notification sends the reminder, ICP adds the care goal, RPM captures the BP reading. A gap counts as closed only when the measure recomputes.
Labs, device vitals, immunization registries, HIE feeds, and faxed charts read by the Intake Agent become coded FHIR evidence, with lineage back to the source page for your HEDIS auditor.
Projected year-end rates against cut points, plus the exact members who move a measure from 3 to 4 stars, ranked by Star impact per dollar spent.
Point-of-care gap lists and closure scorecards for contracted groups, because half of all gaps close in the exam room, not on the phone.
Find. Engage. Prove. Measure.
Built for SNPs
Care for Older Adults, Transitions of Care, and HRA timeliness are where SNPs lose points. StarsIQ ties quality gaps directly into Model of Care workflows, so the HRA that satisfies CMS also captures the depression screening, pain assessment, and medication review that count toward HEDIS.
One command view for the whole Stars team
The result
- Gaps worked within days of opening, not months after a vendor file.
- Closed care becomes counted care, with evidence captured electronically as hybrid sampling disappears.
- Bonus revenue protected, because you know which members move which measure past which cut point, while there’s still time to act.
Compliance & integration
FHIR-native and connected through health3d.ai to QNXT, Facets, TriZetto, EMRs, and HIEs. HIPAA and SOC 2. Human-in-the-loop review on every exception. Member outreach stays within CMS communication rules.