Health plans and provider organizations subject to STAR and HEDIS measures face a dual challenge: improving patient outcomes while reducing administrative overhead.
With its AI-powered digital health platform, HealthCheck offers an end-to-end solution that helps teams close care gaps, improve documentation, and enhance member engagement—all critical levers for optimizing quality scores.
Proactive Outreach and Engagement
HealthCheck’s intelligent agent NudgeAI automates member outreach based on:
Gaps in care
Overdue screenings
Preventive service reminders
Using data from claims, EHRs, or HEDIS-reported measures, NudgeAI:
Sends multilingual messages via SMS, email, or voice
Encourages annual wellness visits, vaccinations, and screenings
Follows up after no-shows or incomplete care steps
This increases compliance and helps members stay on track—especially in high-impact STAR domains.
Automated Documentation and Data Capture
Through integrations with FHIR-based EHRs, pharmacy systems, and claims APIs, HealthCheck agents like NoteGen and CodeMate ensure:
Accurate, structured documentation of key HEDIS metrics (e.g., diabetes eye exams, medication adherence, cancer screening)
Support for CQL generation and structured value set matching
Cleaner documentation for audit-ready STAR reviews
With reduced manual entry, clinicians can focus more on care, and data accuracy boosts quality performance.
Closing Gaps with At-Home and Virtual Tools
HealthCheck supports hybrid care delivery, allowing plans to:
Mail at-home testing kits with tracking and digital instructions
Deliver results through the member portal
Trigger auto-referrals for needed follow-up
This is especially effective for measures like:
Colorectal cancer screening
Blood pressure monitoring
HbA1c collection
Quality Dashboards and Predictive Analytics
HealthCheck provides real-time dashboards to track:
HEDIS measure completion rates
STAR performance by cohort, region, or risk tier
Predictive tools help teams:
Identify members at risk of falling out of compliance
Prioritize interventions based on predicted ROI and health impact
This enables proactive care management aligned with CMS quality goals.
Secure, Scalable, and Aligned with Value-Based Care
All tools are:
HIPAA-compliant
FHIR-native
Designed for diverse member populations
Whether you’re a Medicare Advantage plan targeting 5-star performance, or a Medicaid MCO improving outcomes in high-need areas, HealthCheck adapts to your needs.
Quality That Pays Off
HealthCheck isn’t just about automation—it’s about impact.
And for organizations graded on quality, retention, and value, that impact translates directly into:
Higher scores
Better care
Increased revenue