Empower Your Providers, Raise Your Rates

May 5, 2021 | Solutions

What if you could automatically read every member’s chart and pinpoint gaps that are truly open, where providers need to intervene? Astrata’s NLP technology can!

Empowering your providers to raise their clinical quality rates is an important step in the journey to value-based care. But right now, providers face substantial challenges in making meaningful change using the data most health plans share with them. Health plans are often limited to sharing claims data or narrowly specific types like labs and pharmacy data. 

What if your Health Plan could automatically read every member’s medical chart, and divide all your gaps into actionable groups. Gaps that….

  • Already have enough documentation in clinical notes for abstractors to close them
  • Are almost closeable, but need known additional documentation to meet the HEDIS spec
  • Are truly open, and require provider intervention

Astrata’s technology can group gaps this way, giving you an actionable, accurate, provider-focused gap list.

More signal + less noise = less abrasion

Astrata helps you manage your gap list in an entirely new way. Ilimits noise to your providers by removing gaps that can be closed with existing EMR documentation. Providers can focus their attention on the gaps they need to take action to close. 

Here’s how Astrata’s NLP technology is already helping major health plans raise their clinical rates.

1. Increased time to take action. Identifying clinical rates closer to real time helps providers better understand their quality needs, and take action with specific members. They’ll know where they stand, all year round. 

2. Fewer and better documentation requests. Astrata’s NLP pinpoints and highlights HEDIS leadsencounter dates, and other clues that help your providers focus and find answers. Instead of burying them under a long list of undifferentiated gapsyou’ll help them target their available effort to a smaller, richer fraction of gaps where additional effort is much more likely to yield results.

3. Better abstraction. Astrata’s technology helps your abstractors identify more HEDIS evidence and code to the top of what the HEDIS spec allows. If you’re doing yearround review on selected measures to raise your clinical rates, you’ll keep your abstractors from diverging. You can also target and monitor missed opportunities, so you report the clinical rates you really achieved, instead of something less.

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