Boost Star Ratings, Close Care Gaps, and Maximize Reimbursements
AI-powered platform that helps insurance companies and Medicare Advantage plans achieve 4+ Star Ratings through automated care gap closure and quality improvement
Key Benefits
Achieve 4+ Star Ratings
Improve quality metrics like diabetes management and medication adherence that directly drive Star Ratings.
Close Care Gaps
Track critical care gaps such as A1C tests, medication adherence, and screenings in real time for faster intervention.
Maximize Reimbursements
Improve risk adjustment coding, reduce claim denials, and unlock higher incentive payments.
Provider Efficiency
Reduce clinician burnout by automating documentation, giving providers more time for patient care.
Use Cases
Diabetes Management
Automate tracking of HbA1c, blood pressure, and cholesterol management to improve compliance and quality outcomes.
Medication Adherence
Track medication adherence and provide real-time alerts for non-compliant patients to improve care quality.
Star Ratings
Streamline documentation to meet CMS standards, supporting improvements in quality ratings and financial bonuses.
Risk Adjustment Coding
Ensure accurate and compliant coding, enhancing risk adjustment and maximizing reimbursement potential.
How It Works
Real-Time Adherence Tracking
Automatically flag patients below the adherence threshold and provide alerts for timely interventions.
Care Gap Identification
Dashboards pinpoint overdue tests and missed medications, enabling immediate action to close gaps.
EHR Integration
Syncs with existing EHR systems like Epic, Meditech, and Cerner to ensure seamless data exchange and accurate documentation.
Automated Risk Adjustment
OrbDoc streamlines coding, ensuring precise documentation and alignment with quality metrics to improve reimbursement.
Metrics That Matter
Improvement in Medication Adherence
Track and act on medication non-adherence early to boost compliance rates
Faster Care Gap Closure
Identify and close care gaps more efficiently, reducing delays in care
Stars Achievement
Meet and exceed CMS quality measures for higher Star Ratings and greater financial incentives
Comprehensive Star Measure Coverage
Medication Adherence
- Diabetes Medication Adherence (PDC)
- Hypertension Medication Adherence (PDC)
- Cholesterol Medication Adherence (PDC)
Clinical Quality
- Diabetes Care - A1C Testing
- Diabetes Care - Eye Exam
- Controlling Blood Pressure
- Breast Cancer Screening
- Colorectal Cancer Screening
Patient Experience
- Getting Needed Care
- Getting Appointments Quickly
- Care Coordination
- Overall Rating of Health Plan
Administrative
- Appeals Auto-Forward
- Appeals Upheld
- Complaints About the Health Plan
- Members Choosing to Leave
What Sets OrbDoc Apart?
Real-Time Gap Closure
Close care gaps such as missed tests or prescriptions quickly by flagging them in real time, so providers can intervene before issues escalate.
Proven ROI
Improve quality metrics, reduce administrative burden, and enhance reimbursement potential by optimizing documentation processes.
Seamless EHR Integration
Works directly with your existing EHR systems without disrupting current workflows, enhancing efficiency and compliance.
Calculate Your Star Rating Impact
For a plan with
50,000 members
Improving to 4+ stars
$15M+ bonus
ROI timeline
6-12 months
"OrbDoc transformed our Star Ratings performance. We went from 3.5 to 4.5 stars in just 18 months, unlocking over $12 million in quality bonuses. The real-time care gap alerts and automated interventions made all the difference."
Sarah Johnson
VP of Quality, Regional Medicare Advantage Plan
FAQs
OrbDoc helps by automating care gap tracking and enhancing documentation to meet CMS quality standards for better Star Ratings. Our AI-powered platform monitors all HEDIS measures in real-time, automatically flags care gaps, and ensures proper documentation of interventions. This comprehensive approach typically results in 0.5-1.0 star improvement within the first year.
OrbDoc integrates with Epic, Meditech, Cerner, Athenahealth, NextGen, eClinicalWorks, and other leading EHR systems to ensure accurate data exchange and compliance. Our integration process typically takes 1-2 weeks and includes bi-directional data sync, real-time updates, and automated workflows that work seamlessly with your existing infrastructure.
OrbDoc tracks patient adherence and identifies missed tests, ensuring care gaps are closed in real time. Our platform automatically monitors overdue screenings, missed appointments, medication non-adherence, and incomplete preventive care measures. It generates prioritized worklists for care teams and automates outreach to patients, resulting in 30-40% faster gap closure rates.
OrbDoc addresses all major CMS Star Rating categories including medication adherence (diabetes, hypertension, cholesterol), clinical quality measures (A1C control, blood pressure control, breast cancer screening), patient experience (CAHPS), and operational measures (appeals, complaints). Our comprehensive approach ensures no measure is overlooked.
Most plans see measurable improvements within 3-6 months of implementation. Early wins include improved medication adherence rates (typically 15-20% improvement in first quarter) and faster care gap closure. Full Star Rating improvements are typically realized in the 12-18 month measurement cycle, with many clients achieving 4+ stars within their first full year.
Maximize Your Star Rating Performance
Ready to Achieve 4+ Star Ratings?
Join leading Medicare Advantage plans using OrbDoc to improve quality metrics, close care gaps, and maximize reimbursements
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