Astrata has been named a recipient of the KLAS Payer/Provider Points of Light Award in collaboration with AmeriHealth Caritas, ELLKAY, and Prospect Medical Holdings, Inc. for its work in Closing Care Gaps for Healthcare Effectiveness Data and Information Set(HEDIS)Measures through Natural Language Processing (NLP).

The Points of Light Awards celebrate success stories—or Points of Light—from payers, providers, and healthcare technology companies that work collaboratively to align care delivery with health plan sponsor initiatives to reduce inefficiencies and improve the patient experience.

“We are delighted that KLAS Research honored Astrata with this award, recognizing our success in the payer/provider initiative to support health plans’ quality programs.” said President of Astrata, Rebecca Jacobson, “We continue to enable organizations to move to continuous prospective HEDIS by increasing efficiency in identifying care gaps, allowing for fewer cases that need to be manually reviewed and providing better patient/member care.”

Astrata offers a proven, HITRUST-certified solution to impact payers’ quality reporting, reducing provider abrasion and improving patient care and outcomes. This acknowledgment from KLAS is a testament to the value that Astrata is delivering to healthcare quality as it continues to focus on accelerating value-based care.

This program was the result of Prospect Medical Holdings and AmeriHealth Caritas collaborating to “ensure that patient compliance with Medicaid measures was accurately measured, recorded, and reported to the state. Provider and payer organizations need accurate measurements to improve patient/member care, reduce the provider administrative burden, and produce more accurate data for HEDIS reporting. Standard industry practices rely primarily on claims data to close HEDIS gaps. However, because clinicians often use free-text clinical notes to document compliance, structured claims data alone does not provide a complete picture of a member population’s compliance with Medicaid measures. As the National Committee for Quality Assurance (NCQA) moves toward digital measures, payer and provider organizations are at risk of significantly underestimating their HEDIS compliance.” as noted in the case study.

Key outcomes from the collaboration include:

• Indications of increased efficiency in identifying care gaps and increased financial return from quality measures
• Reduced redocumentation efforts for Prospect Medical Holdings
• Reduced number of care gaps that need manual review
• Comprehensive member follow-up on care gaps

Astrata and AmeriHealth Caritas are continuing to work together to review opportunities to expand the program.

Vandna Bhrany, VP HEDIS Strategy & Analytics at AmeriHealth Caritas stated, “Moving to a year-round HEDIS program is a fundamental shift that supports better population health and helps us achieve value-based care goals. An underlying NLP platform is an essential element of scaling the work. We are delighted to receive this Points of Light award with our collaborators from Prospect Medical Holdings, Astrata, and ELLKAY.”

Patricia Warble, Senior Director at Prospect Medical Holdings, went on to say, “This collaborative effort generated increased opportunities for quality improvements by providing a more complete picture of compliance.  Reducing burden for our providers is a key goal of this project.”

The recognition of Astrata with a 2024 KLAS Points of Light Award highlights the transformative potential of collaboration.  Solutions that enable providers and payers to have clear insight into care gaps can drive greater improvements in patient outcomes. Additional value is found in the reduction in redocumentation efforts for closing care gaps and manual record requests from health plans. Astrata’s innovative approach empowers organizations to move from a retrospective HEDIS approach to a prospective HEDIS strategy. This allows for payers, providers, and patients to work in concert to identify and close gaps in care that affect patient outcomes within the measurement year.

 

About KLAS

KLAS is a research and insights firm on a global mission to improve healthcare. Working with thousands of healthcare professionals and clinicians, KLAS gathers data and insights on software and services to deliver timely reports and performance data that represent provider and payer voices and act as catalysts for improving vendor performance. The KLAS research team publishes reports covering the most pressing questions facing healthcare technology today, including emerging technology insights, that provide early insights on the future of healthcare technology solutions. KLAS also fosters measurement and collaboration between healthcare providers and payers and best practice adoption. Learn more at KLASresearch.com.

About Astrata

Astrata is a digital quality company, offering a suite of products and services for health plans and value-driven providers who are moving from paper-based clinical quality measures to digital clinical quality measures, as required by NCQA and CMS. Astrata’s products make it possible to better measure and improve healthcare quality, a foundation for moving to value-based care. Astrata’s value propositions include dramatic efficiency gains, higher clinical quality rates, and increased quality bonus payments.