HEDIS · HCC Recapture · Autonomous Outreach
Stop Leaving Quality Bonus
Money on the Table.
GapClose automatically identifies and closes HEDIS care gaps for independent primary care practices. CSV in. Gaps closed. Bonus secured.
Currently onboarding pilot practices. We confirm BAA coverage before any practice uploads PHI.
14+
HEDIS measures
$150+
avg per closed gap
8x
typical ROI
Days
to go live
Pilot
practices welcome
The Problem
You're leaving money on the table
Independent primary care practices in Medicare Advantage and value-based contracts can leave thousands of dollars per provider in quality bonus payments on the table each year due to undocumented or overlooked HEDIS gaps. Actual dollar impact varies with panel size, payer mix, and existing reporting workflows.
01
Enterprise tools cost $5K+/mo and require 6-month implementations
02
Your EHR doesn’t track gaps across payers
03
Your staff doesn’t have time to manually review 2,000 patients
Built for Primary Care
One tool. Your entire revenue cycle.
Everything a practice on value-based contracts needs — in one place.
Gap Management
Prioritized gap worklist, automatically sorted by revenue impact
James Martin ···4229Medicaid
CDC A1C
$2,400
Susan Rodriguez ···8821Medicare Adv.
BCS
$1,800
David Thompson ···3344Commercial
CBP
$1,200
Maria Wilson ···7712Medicare
AWV
$950
47 open gaps · revenue impact calculatedBulk close →
HCC Recapture
RAF
weighted opportunities
sorted by revenue impact
sorted by revenue impact
HCC codes tracked with real RAF weight. One-click confirm, defer, or reject — routed to the right provider automatically.
HCC 19 Diabetes
0.318
HCC 85 CHF
0.368
HCC 108 Vascular
0.251
HCC 111 COPD
0.196
Autonomous Outreach
AI writes and sends patient outreach — zero staff time
AI-generated patient letters, provider daily digests, and executive reports — via your own SMTP server or our built-in delivery.
Gap Closure Campaign — 47 emails queued
Provider Digest — sent daily at 7am
Executive Report — auto-generated weekly
Coverage
14 HEDIS measures and growing. Payer-specific thresholds.
Covers the highest-value quality gaps: A1C, blood pressure, cancer screenings, wellness visits, and more. Medicare vs. Commercial thresholds applied automatically.
CDCCBPBCSCCSCOLAWVPHQ-9SPRFUHURIHBAWCC
HIPAA-Conscious
AES-256
Encrypted PHI fields
Append-only audit log, role-based access control, zero PHI in logs or external services. HIPAA-conscious architecture; full BAA coverage confirmed in writing before pilot onboarding.
✓Append-only HIPAA audit log
✓Role-based access control (RBAC)
✓PHI redacted from logs + analytics
✓AES-256 encrypted fields at rest
Setup
Up and running in minutes
No EHR integration. No IT project. Just upload a CSV.
01 — Upload
Export a CSV from your EHR
Epic, Athena, eCW, or any system. Intelligent field mapping handles messy real-world data automatically.
02 — Scan
GapClose scans overnight
Every patient scored against 14 key HEDIS measures and HCC codes. Payer-specific criteria applied automatically.
03 — Act
Prioritized worklist, zero effort
Providers get a daily digest. Care coordinators see a revenue-sorted gap list. AI letters go out to patients automatically.
04 — Track
Close gaps, capture revenue
Revenue impact calculated in real time as gaps close. Executive reports show progress against quality targets.
Any EHR — No Integration Required
Works with Epic, Athena, eCW, and any system that exports CSV
Intelligent field mapping handles column names like DOB, date_of_birth, or patient_dob automatically.
Supported EHR Exports
✓Epic MyChart / Clarity
✓Athena Health (athenaOne)
✓eClinicalWorks
✓Greenway Health (Intergy)
✓Practice Fusion
✓Any CSV export
Why GapClose
GapClose vs. Enterprise Solutions
ROI Calculator
See your potential return
Drag the sliders to estimate the revenue impact for your practice.
5005,000
0%100%
Estimated open gaps
180
Quality bonus at risk
$27,000
GapClose cost
$7,188/year
ROI
3.8x
Pricing
Simple, transparent pricing
Pilot pricing available. We confirm BAA coverage before any practice uploads PHI.
Starter
$299/mo
Up to 1,000 patients · 3 users
Request Pilot Access- ✓14 HEDIS measures (expanding)
- ✓HCC recapture tracking
- ✓CSV import + field mapping
- ✓Automated patient outreach
- ✓3 report types
- ✓Email support
Growth
$599/mo
Up to 5,000 patients · 10 users
Request Pilot Access- ✓Everything in Starter
- ✓All 5 report types
- ✓Payer performance analytics
- ✓Multi-provider workflow
- ✓Custom SMTP email sending
- ✓Priority support
Group / IPA
$799/mo
Unlimited patients · Unlimited users
Request Pilot Access- ✓Everything in Growth
- ✓Multi-practice dashboard
- ✓Consolidated reporting
- ✓Custom payer integrations
- ✓Dedicated onboarding
- ✓Priority support
Enterprise
$1,199/mo
Unlimited patients · Unlimited users
Request Pilot Access- ✓Everything in Growth
- ✓Unlimited users
- ✓Custom reporting
- ✓Dedicated onboarding
- ✓Phone + email support
- ✓Annual billing available
Annual plans save ~20%. Cancel anytime. All plans include HIPAA-conscious data handling.
FAQ
Frequently asked questions
Everything you need to know about GapClose.
What is HEDIS and why does it matter?
HEDIS (Healthcare Effectiveness Data and Information Set) is the most widely used set of healthcare performance measures in the United States. Payers use HEDIS scores to determine quality bonuses and Star Ratings. Closing HEDIS gaps directly increases reimbursement and improves patient outcomes.
How does GapClose identify care gaps?
GapClose scans your patient panel against 14 key HEDIS measures nightly, covering the highest-value quality gaps like A1C control, blood pressure, cancer screenings, and annual wellness visits. It applies payer-specific thresholds and surfaces every open gap, sorted by revenue impact.
Do I need to integrate with my EHR?
No. GapClose works with a simple CSV export from any EHR — Epic, Athena, eClinicalWorks, or any system. Our intelligent field mapping handles different column names and formats automatically. No IT project required.
Is patient data secure? Is GapClose HIPAA-compliant?
GapClose is architected for HIPAA from the ground up: AES-256 encryption of PHI fields at rest, an append-only audit log, role-based access control, and zero PHI in logs or third-party services. However, HIPAA compliance for any vendor handling PHI also requires signed Business Associate Agreements with all sub-processors. Several of our sub-processor BAAs are still being executed, so GapClose is currently in pre-pilot status and is not yet accepting production PHI from outside practices. We will confirm BAA status in writing before any practice uploads real patient data. Contact us to discuss pilot timing.
How long does setup take?
Most practices are up and running within minutes. Export a CSV from your EHR, upload it to GapClose, and your first gap analysis runs overnight. No integration, no IT tickets, no waiting.
What kind of support do you offer?
Starter plans include email support. Growth plans receive priority support with faster response times. Enterprise plans include dedicated onboarding, phone support, and a named account manager.
Founding Partner Program
Be a founding practice and shape the future of gap closure
We're partnering with a small number of independent practices to refine GapClose. Founding partners get direct access to the team, priority feature requests, and locked-in pricing for life.
Get Started
Ready to find out what's
sitting in your panel?
Independent practices in Medicare Advantage and value-based contracts leave real money on the table from uncollected HEDIS bonuses each year.
GapClose helps you find and close those gaps.
Currently onboarding pilot practices. We confirm BAA coverage before any practice uploads PHI.