Health Plans

Health Plans

Virtual HEDIS Gap Closure & Annual Wellness Visits


The members preventing plans from reaching 4 and 5 Stars are often the hardest to engage, and the least likely to see their PCP. CTH proactively engages these members through multi-modal outreach, and completes virtual Annual Wellness Visits to close 14+ HEDIS gaps.

 

When brick-and-mortar providers can't close gaps, our nationwide network of CMS-licensed virtual physicians extends clinical capacity by delivering comprehensive virtual care without adding work for plans or disrupting provider networks.

 

The result is a scalable, end-to-end quality solution that helps health plans improve Star Ratings, increase preventive care completion, and reach members traditional care models leaves behind.


Health Plan Fact Sheet
Case Study

Virtual HEDIS Gap Closure & Annual Wellness Visits


Stop Chasing Care Gaps. Start Closing Them.


The members preventing plans from reaching 4 and 5 Stars are often the hardest to engage, and the least likely to see their PCP. CTH proactively engages these members through multi-modal outreach, and completes virtual Annual Wellness Visits to close 14+ HEDIS gaps.

 

When brick-and-mortar providers can't close gaps, our nationwide network of CMS-licensed virtual physicians extends clinical capacity by delivering comprehensive virtual care without adding work for plans or disrupting provider networks.

 

The result is a scalable, end-to-end quality solution that helps health plans improve Star Ratings, increase preventive care completion, and reach members traditional care models leaves behind.

Virtual HEDIS Gap Closure & Annual Wellness Visits


The members preventing plans from reaching 4 and 5 Stars are often the hardest to engage, and the least likely to see their PCP. CTH proactively engages these members through multi-modal outreach, and completes virtual Annual Wellness Visits to close 14+ HEDIS gaps.

 

When brick-and-mortar providers can't close gaps, our nationwide network of CMS-licensed virtual physicians extends clinical capacity by delivering comprehensive virtual care without adding work for plans or disrupting provider networks.

 

The result is a scalable, end-to-end quality solution that helps health plans improve Star Ratings, increase preventive care completion, and reach members traditional care models leaves behind.


Health Plan Fact Sheet
Case Study




Improve quality scores with Virtual HEDIS Gap Closure and Annual Wellness Visits

 

Health plans face persistent barriers when it comes to closing HEDIS gaps and capturing accurate risk adjustment - member engagement is low, PCP capacity is limited, and timely access to HIE data remains fragmented. 

CareTalk Health simplifies this process - Our national network of virtual-only providers proactively engages members and conducts virtual visits using real-time clinical data insights. These insights enable our providers to complete virtual AWVs, close HEDIS gaps, and capture risk adjustment in real-time. Following each visit, our care navigation team manages any remaining actions needed to close outstanding gaps and shares the results with the plan before submitting a claim. 

Available 24/7 across all 50 states, CareTalk Health clinicians are CMS-credentialed and operate within the fee-for-service framework - allowing services to be billed directly through the CMS fee schedule and eliminating financial risk for health plans.



DID YOU KNOW ?

DID YOU KNOW ?

Less than 50% of MA members complete their annual wellness visit (AWV), yet it is the leading indicator that a member will close their care gaps.

That’s why CareTalk Health built a virtual care gap closure program around proactively engaging members to complete AWVs.

10-20% of members fail to complete their annual wellness visit (AWV), yet it is the leading indicator for health plans that a member will close their care gaps and have better health outcomes.

That’s why CTH built a virtual care gap closure program around proactively engaging members to complete AWVs.

10-20% of members fail to complete their annual wellness visit (AWV), yet it is the leading indicator for health plans that a member will close their care gaps and have better health outcomes.

That’s why CTH built a virtual care gap closure program around proactively engaging members to complete AWVs.

DID YOU KNOW ?

10-20% of members fail to complete their annual wellness visit (AWV), yet it is the leading indicator for health plans that a member will close their care gaps and have better health outcomes.

That’s why CTH built a virtual care gap closure program around proactively engaging members to complete AWVs.

Challenge

Hard-to-reach members remain non-compliant despite repeated outreach.





Challenge

Plan care management teams waste time chasing after members who have already closed their care gaps


Solution

CTH proactively engages non-compliant members and closes care gaps through real-time virtual care.

Challenge

Primary care shortages limit timely access to preventive care.

Solution

CareTalk Health physicians access HIE data and review clinical history to close gaps in real-time

Solution

CareTalk Health physicians access HIE data and review clinical history to close gaps in real-time

Solution

Our nationwide virtual provider network expands clinical capacity without adding strain to PCPs.

Challenge

Health plans struggle to improve quality without increasing costs.

Solution

CareTalk Health PCPs educate members focus on completing AWVs and closing gaps

Solution

Our fee-for-service model delivers measurable quality improvements with no PMPM or implementation fees.

Turning Challenges Into Solutions

Challenge

Hard-to-reach members remain non-compliant despite repeated outreach.


Hard-to-reach members remain non-compliant despite repeated outreach.

Solution

CTH proactively engages non-compliant members and closes care gaps through real-time virtual care.

Our physicians access HIE data and review clinical history to close gaps in real-time

Challenge

Primary care shortages limit timely access to preventive care.

Solution

Our nationwide virtual provider network expands clinical capacity without adding strain to PCPs.

Our PCPs educate members focus on completing AWVs and closing gaps

Challenge

Health plans struggle to improve quality without increasing costs.

Solution

Our fee-for-service model delivers measurable quality improvements with no PMPM or implementation fees.

Our physicians keep utilization and ordering costs in mind. Their virtual visits are billed as in-network AWVs.

Turning Challenges Into Solutions

Turning Challenges Into Solutions

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