Home » Care Gap Closure

Proven to Close More Care Gaps

Close more care gaps to improve quality ratings and increase CMS reimbursement.

Solution

Health plans close more member care gaps with care navigators who conduct member outreach, schedule preventive care (improving show rate by 60% or more and driving more in-network visits) and capture the results back to the member’s PCP. With more care gaps closed and greater member satisfaction, payers improve quality ratings and drive higher CMS reimbursement rates and revenues.

How it Works

  • Care navigators find the right providers(s) and schedule preventive care appointments for members at the referable moment.

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    Members receive email and text reminders and are more likely to follow through with their preventive care screenings.

  • Share clinical data between providers via a HIPAA-secure conduit, across all EMRs, ensuring the PCP is in the loop and the plan is informed of the visit status.

  • Care navigators can be employed by the plan, if preferred.

Increase Your Revenue

Increase revenues by improving HEDIS measures and Star ratings.

Reduce costs by increasing preventive screenings, saving downstream spend.

Improve revenue by improving efficiency and efficacy of outreach programs.

Get More Members to Schedule Preventive Care


Colorectal Cancer Screenings


Diabetic Retinopathies


Mammograms


Annual Wellness Visits


Prenatal Care Visits

Benefits of ReferWell’s Care Gap Closure Solution

Increase CMS Reimbursements

Close more care gaps, improving HEDIS scores and increase member satisfaction for higher Star ratings.

Augment Internal Care Coordinators

ReferWell care coordinators offer a flexible staffing option; they can be deployed to augment your existing staff when needed.

Improve Preventive Care Compliance

Patient show rate dramatically increases when the appointment is booked ‘right then and there’ with an in-network doctor, at a convenient location and time.

Track and Resolve Patient Data

ReferWell helps capture the relevant appointment data for prior preventive care so the PCP can keep their patient records up to date.

Expert Care Navigators to Call Members and Schedule Care Gap Appointments

ReferWell care navigators are your call center staff to engage members and schedule care gap appointments. Multi-lingual and experienced in patient-facing clinical settings, they are experts in educating members on the value of preventive care and addressing barriers members may face in seeking care. With flexible night and weekend schedules and carefully crafted scripts, care navigators have a track record of increasing member reach and impact rates.

Start closing care gaps today.

See how ReferWell impacted 77% of members’ care gaps for colorectal cancer screening (COL). Get your copy of the case study now.

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