Quality IQ
Supporting Real-Time HEDIS Gap Closure for Health Plans
Quality IQ detects time-sensitive HEDIS and CMS Star care gaps in real time—the moment a member enters a denominator, not weeks later through claims. It prioritizes each gap by urgency, consolidates multiple gaps per member, and gives your team a single worklist so they can act immediately and protect quality-linked revenue.
Why Health Plans Choose Quality IQ
Protect Quality Revenue
Identify care gaps for HEDIS and CMS Star Measures in real time and prioritize by urgency so your team maximizes care gap closure that drives revenue before the window shuts.
Extend Your Team’s Reach
Reach every member in a time-sensitive denominator—not just those enrolled in care management—with consolidated worklists and shared tracking.
Close Multiple Measures
When gaps overlap in the post-discharge window, one outreach can move multiple quality measures at once, multiplying impact without more effort.
The Operational Edge Your Quality Team Is Missing
Care gaps detected and surfaced the moment they open
Real-time HEDIS and CMS Star denominator detection through continuous ADT monitoring
Quality IQ monitors ADT events across 2,800+ hospitals and 3,600+ clinics for over 100M members in real time. The moment a member’s event triggers a time-sensitive HEDIS denominator, it’s identified, giving your team the full measurement window to act.
Every gap ranked by urgency. Shortest window first.
Urgency-based stratification with days remaining, deadline date, and gap detail
Every open gap shows how many days remain, the deadline date, when it opened, and the measure. Your team sees the full picture at the list level and the member level, so effort is concentrated on cases where the window is closing, not spread evenly across a static report.
Every gap, every contact, every status in one view.
Consolidated gaps per member with contact details, care team info, and status tracking
All open care gaps for a member are grouped in one view alongside risk level, phone numbers, and care team details. Care managers mark each case, move to the next, and the whole team sees the status—no duplicate outreach, no gaps slipping through unworked.
Care gaps detected and surfaced the moment they open
Real-time HEDIS and CMS Star denominator detection through continuous ADT monitoring
Quality IQ monitors ADT events across 2,800+ hospitals and 3,600+ clinics for over 100M members in real time. The moment a member’s event triggers a time-sensitive HEDIS denominator, it’s identified, giving your team the full measurement window to act.
Every gap ranked by urgency. Shortest window first.
Urgency-based stratification with days remaining, deadline date, and gap detail
Every open gap shows how many days remain, the deadline date, when it opened, and the measure. Your team sees the full picture at the list level and the member level, so effort is concentrated on cases where the window is closing, not spread evenly across a static report.
Every gap, every contact, every status in one view.
Consolidated gaps per member with contact details, care team info, and status tracking
All open care gaps for a member are grouped in one view alongside risk level, phone numbers, and care team details. Care managers mark each case, move to the next, and the whole team sees the status—no duplicate outreach, no gaps slipping through unworked.
If we had continued to practice the way we were, we wouldn’t have captured any of the withhold revenue. Quality IQ gave us real-time visibility into care gaps we were missing entirely and the tools to act before the window closed.
Chief Medical Officer
National Virginia Medicaid Plan
$3.4M
Projected HEDIS revenue captured across time-critical measures
$2.3M
Utilization savings from timely post-discharge intervention
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Take a Closer Look
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See Quality IQ in Action
Watch a short on-demand demo to preview how Quality IQ helps health plans close care gaps in real time and protect quality-linked revenue.