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Solution
v3.3.0
FHIR R4 Validated
HIPAA Ready

Care Gap Analyzer

Close HEDIS care gaps at scale with AI-driven outreach

by CareCORE Analytics
4.6(167 reviews)
2,100 deployments

About

Care Gap Analyzer from CareCORE Analytics continuously analyzes patient populations against 78 HEDIS, CMS Stars, and commercial quality measures, identifying open gaps, supplemental data opportunities, and estimated closure rates. It integrates with claim feeds, EHR data via FHIR Bulk Export, and health plan rosters to provide a unified care gap registry. AI-powered outreach scoring ranks patients by closure probability and assigns them to appropriate outreach modalities — automated text (via Twilio), nurse call campaign, or portal message. In partner value-based care programs, Care Gap Analyzer has improved HEDIS composite scores by an average of 7.3 quality points in the first performance year.

Key Features

  • 78 HEDIS, CMS Stars, and commercial quality measure library
  • Supplemental data ingestion to close chart-confirmed gaps
  • AI-powered patient outreach priority scoring
  • Multi-channel outreach: SMS, portal message, nurse call queue

78

Quality Measures Covered

+7.3 pts

HEDIS Score Improvement

41%

Gap Closure Rate

28%

Outreach Engagement Rate

64%

Supplemental Data Hit Rate

Accredited

NCQA Accreditation

HIPAA BAA included with all enterprise plans

Compliance

HIPAA BAA
SOC 2 Type II
NCQA Accredited
CMS Stars Aligned

Tags

HEDIS
Quality Measures
Care Gaps
Value-Based Care
Population Health
Stars Rating
FHIR R4
CategoryQuality Management
Versionv3.3.0
UpdatedNov 18, 2025
FHIR VersionR4