Part 1: Closing Care Gaps to Achieve Quality Goals

Article 2:

How to Identify and Prioritize Care Gaps

In part 1 of our Delivering Value series we introduce Care Gaps and help you understand how to identify and close them. Our first article in the series defined three principal types of gaps in care: process measure gaps, outcome measure gaps, and paper gaps. We also described the effect that care gaps, real or perceived, have on quality of care and costs.

Successful groups are achieving quality goals by identifying, prioritizing and closing or eliminating all three types of gaps. In article 2 of the series, we explain how to identify care gaps in your own group or practice and how to prioritize closing them to deliver the greatest healthcare value.

Get the Data

As discussed in the last article, care gaps have to be identified by certified HEDIS software that integrates data available to a health plan and determines which members are non-compliant on which measures.  And, care gaps can be real or illusory. Providers often have inconsistent records about services performed for individual patients than health plans have for their same members. This inconsistency results in paper gaps: care gaps that exist in health plan records but not in reality.  Howe