Latest news with #HEDIS
Business Wire
4 days ago
- Business
- Business Wire
Availity and Vim Partner to Streamline Care Gap Notification and Closure Process
JACKSONVILLE, Fla.--(BUSINESS WIRE)--Availity®, the nation's leading real-time health information network, and Vim, a leader in care orchestration for value-based care, have partnered to help payers streamline risk and quality care gap closure and reduce provider abrasion. The partnership leverages a multi-channel approach that surfaces action-oriented risk and quality gaps in providers' electronic health record (EHR) workflow, allowing them to submit the required information quickly and securely, while at the point-of-care. The partnership leverages a multi-channel approach that surfaces action-oriented risk and quality gaps in providers' electronic health record (EHR) workflow, allowing them to submit the required information quickly and securely, while at the point-of-care. Share Achieving this level of efficiency with care gap closure is critical for payers, especially as they look to improve HEDIS® performance and Stars ratings. Many payers still rely on manual, paper-based processes to notify and address care gaps that place a heavy administrative burden on providers, resulting in low adoption and engagement. Leveraging digital payer-provider collaboration and bidirectional EHR integration For more than 20 years, Availity has been a leader in developing digital tools designed to reduce administrative waste and improve payer-provider engagement. Availity was the recipient of the KLAS Points of Light 2025 for its innovative digital tools within Availity's multi-payer provider portal, which streamline quality and risk care gap reporting and closure. 'With Availity and Vim's partnership, the power of this streamlined care gap closure process extends beyond the Availity portal to the EHR, allowing payers to capture the attention of providers closer to the point of care,' said Ashley Basile, Availity Clinical Chief Product Officer. 'Vim seamlessly integrates care gap insights directly into EHR workflows, enabling healthcare providers to work more efficiently, while also enhancing patient outcomes and payer operations. Now Availity can be a one-stop shop for health plans looking maximize care gap closure via multiple provider destinations and workflow tools.' A single source of truth for payers In addition to reducing the administrative burden on providers, the partnership helps payers improve data integrity and reporting by capturing real-time care gap updates through both Vim Connect and Availity's Essentials portal while continuously synchronizing care gap data. 'At Vim, we believe that the future of value-based care depends on meeting providers where they are: inside their workflow, not outside of it. Our expanded partnership with Availity turns that belief into action. By embedding real-time, bidirectional data exchange directly into EHRs, we're removing the friction that slows down care and creating scalable infrastructure for payers and providers to align. This is what seamless, connected healthcare looks like,' said Josh Stern, Chief Business Officer of Vim. About Availity Availity is the trusted partner for organizations seeking to realize the greatest value from clinical, administrative, and financial data. Positioned at the nexus of provider, health plan, and consumer health information, Availity develops scalable, innovative solutions for healthcare data acquisition, standardization, transparency, automation, and exchange. As one of the nation's largest health information networks, Availity facilitates billions of clinical, administrative, and financial transactions annually—powering real-time collaboration in a dynamic, value-based care environment. About Vim Vim is a provider engagement platform for healthcare. Its flexible and scalable platform and unique and interactive integration layer unlock access to provider EHR workflows, allowing for the delivery of data, patient insights, and applications at the point of patient care. Vim's partners can leverage Vim's core applications or deploy their custom applications on top of Vim Connect – Vim's in-EHR connectivity layer – accelerating time to market at reduced cost and improved flexibility. Digital health builders of all sizes, including national health plans, leading ACOs and MSOs, and tech companies, use Vim's platform to connect with more than 50,000 providers. For more information, visit
Yahoo
4 days ago
- Business
- Yahoo
Firefly Health Drives Virtual Care Quality as First National Primary Care Practice to Achieve NCQA Accreditation
WATERTOWN, Mass., June 04, 2025--(BUSINESS WIRE)--Firefly Health, a pioneer in virtual-first care, is among five organizations nationwide to earn the prestigious NCQA Virtual Care Accreditation. Importantly, Firefly is the first national primary care practice to receive this designation, distinguishing itself from other accredited programs operating in limited states or providing non-longitudinal care. As healthcare shifts to virtual and hybrid modalities, NCQA identified a need for standardized, safe, effective, and equitable frameworks. Firefly was a key collaborator in this two-year pilot, helping to both develop and then apply for the program. "NCQA's commitment to quality and patient-centered care aligns with Firefly's mission. Achieving one of the first virtual primary care accreditations reinforced our dedication to high-quality care and strengthened our processes. We're excited to continue partnering with NCQA to set the standard for virtual care, expanding access to patients nationwide," said Dr. Nisha Basu, Chief Clinical Officer of Firefly Health. The NCQA Virtual Care Accreditation standards address vital elements of quality and patient protections. Key areas include ensuring personalized, actionable treatment plans that demonstrate a real investment in the patient beyond a virtual interaction. This means assessing virtual care suitability, ensuring translation services, identifying external resources, and utilizing the virtual setting to gather comprehensive patient information, including social determinants of health. Aligning with NCQA's framework, Firefly refined its operations. This included developing detailed Standard Operating Procedures for technology, clinical, and operational practices, and strengthening training. The company also improved its Race, Ethnicity, and Identity (REI) data collection to continually address evolving patient needs. About Firefly Health Firefly is a primary care and health plan provider serving members and employers nationally. Through their hybrid primary care offering, Firefly delivers team-based care that seamlessly integrates primary care, chronic condition management, mental healthcare, and specialty care into its affordable employer-sponsored health plan. Learn more at About NCQA NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA's Healthcare Effectiveness Data and Information Set (HEDIS®) is the most widely used performance measurement tool in health care. NCQA's website ( contains information to help consumers, employers and others make more informed health care choices. NCQA can be found online at on Twitter @ncqa, on Facebook at and on LinkedIn at View source version on Contacts Liz Kellogg, Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
21-05-2025
- Health
- Yahoo
Availity® Co-Honored with 2025 KLAS Points of Light Awards for Care Gap Closure and Payer-to-Payer Data Exchange
JACKSONVILLE, Fla., May 21, 2025--(BUSINESS WIRE)--Availity, the nation's largest real-time health information network, has been twice named a 2025 Points of Light Award recipient by KLAS Research. These recognitions celebrate two case studies with leading national health plans. One award recognizes Availity's efforts to improve clinical data exchange and provider engagement through innovative digital tools within Availity's multi-payer provider portal, designed to streamline quality and risk care gap reporting and closure. Together, the organizations replaced time-consuming, paper-based processes with integrated, electronic solutions that notify providers of quality and risk documentation gaps and allow them to submit the required information quickly and securely within their existing workflows to document patient care gap closure and support value-based care initiatives. The other award recognizes Availity's work with three national payer organizations to enhance payer-to-payer data exchange by developing a centralized connectivity hub, to accelerate interoperability mandate compliance and facilitate more seamless, interoperable exchange of member health plan data as they transition across plans, ultimately resulting in reducing care gaps, administrative inefficiencies, and data fragmentation during member transitions between health plans. This innovative solution enables multiple payer organizations to reduce the need for establishing multiple end-point connections with health plans, improves continuity of care, and supports compliance with upcoming CMS interoperability mandates. "Availity is proud to be recognized by KLAS, which embodies our shared commitment to reducing administrative burden in healthcare, enhancing the provider experience, and advancing healthcare interoperability," said Ashley Basile, Clinical Chief Product Officer, Availity. "Through our digital care gap tools, we are empowering providers with a unified, multi-payer digital workflow to improve quality reporting and care outcomes. At the same time, our payer-to-payer data exchange initiative is helping health plans support better continuity of care for members as they transition between plans and support CMS mandate compliance." Availity Digital Care Gap Tools Key results from the digital care gap reporting collaboration include 34,000+ quality measures submitted electronically through Availity's multi-payer portal as of October 2024 (an average of two care gaps closed per form submitted during the measurement period). In addition: 70% of network providers now have access to Availity's digital care gap tools, up from just 25% In addition to improved HEDIS and Stars performance, considerable financial savings were generated through: Reduction in need for manual retrieval of medical records to support submissions; estimated $15 - $25 saved per medical record no longer required Reduction in estimated $10,000 in print, mail, and handling costs per quarterly mailing no longer required ($40,000 annually for each quarterly mailer) Payer-to-Payer Data Exchange Key results from the payer-to-payer collaboration include: Successful implementation of a centralized hub-and-spoke model for secure payer-to-payer data exchange Reduced onboarding time and administrative complexity for participating payer organizations Capture of long-term cost savings and improved data accuracy via a platform that delivers multi-payer connectivity efficiencies and economies of scale Strengthened compliance readiness for CMS interoperability mandates effective January 2027 Enhanced continuity of care during member transitions between health plans through faster, standardized data sharing The KLAS Points of Light annual awards celebrate success stories achieved by payers, healthcare organizations, and healthcare IT companies whose partnerships focus on reducing costs and inefficiencies while striving to improve the patient experience. The awards will be presented at the KLAS K2 Collaborative Summit, May 20–22 in Salt Lake City. About Availity Availity is the trusted partner for organizations seeking to realize the greatest value from clinical, administrative, and financial data. Positioned at the nexus of provider, health plan, and consumer health information, Availity develops scalable, innovative solutions for healthcare data acquisition, standardization, transparency, automation, and exchange among health plans, providers, and technology partners. As one of the nation's largest health information networks, Availity facilitates billions of clinical, administrative, and financial transactions annually. Learn more at View source version on Contacts Media Contact: fuocoavaility@ Error in retrieving data Sign in to access your portfolio Error in retrieving data Error in retrieving data Error in retrieving data Error in retrieving data
Yahoo
21-05-2025
- Health
- Yahoo
Availity® Co-Honored with 2025 KLAS Points of Light Awards for Care Gap Closure and Payer-to-Payer Data Exchange
JACKSONVILLE, Fla., May 21, 2025--(BUSINESS WIRE)--Availity, the nation's largest real-time health information network, has been twice named a 2025 Points of Light Award recipient by KLAS Research. These recognitions celebrate two case studies with leading national health plans. One award recognizes Availity's efforts to improve clinical data exchange and provider engagement through innovative digital tools within Availity's multi-payer provider portal, designed to streamline quality and risk care gap reporting and closure. Together, the organizations replaced time-consuming, paper-based processes with integrated, electronic solutions that notify providers of quality and risk documentation gaps and allow them to submit the required information quickly and securely within their existing workflows to document patient care gap closure and support value-based care initiatives. The other award recognizes Availity's work with three national payer organizations to enhance payer-to-payer data exchange by developing a centralized connectivity hub, to accelerate interoperability mandate compliance and facilitate more seamless, interoperable exchange of member health plan data as they transition across plans, ultimately resulting in reducing care gaps, administrative inefficiencies, and data fragmentation during member transitions between health plans. This innovative solution enables multiple payer organizations to reduce the need for establishing multiple end-point connections with health plans, improves continuity of care, and supports compliance with upcoming CMS interoperability mandates. "Availity is proud to be recognized by KLAS, which embodies our shared commitment to reducing administrative burden in healthcare, enhancing the provider experience, and advancing healthcare interoperability," said Ashley Basile, Clinical Chief Product Officer, Availity. "Through our digital care gap tools, we are empowering providers with a unified, multi-payer digital workflow to improve quality reporting and care outcomes. At the same time, our payer-to-payer data exchange initiative is helping health plans support better continuity of care for members as they transition between plans and support CMS mandate compliance." Availity Digital Care Gap Tools Key results from the digital care gap reporting collaboration include 34,000+ quality measures submitted electronically through Availity's multi-payer portal as of October 2024 (an average of two care gaps closed per form submitted during the measurement period). In addition: 70% of network providers now have access to Availity's digital care gap tools, up from just 25% In addition to improved HEDIS and Stars performance, considerable financial savings were generated through: Reduction in need for manual retrieval of medical records to support submissions; estimated $15 - $25 saved per medical record no longer required Reduction in estimated $10,000 in print, mail, and handling costs per quarterly mailing no longer required ($40,000 annually for each quarterly mailer) Payer-to-Payer Data Exchange Key results from the payer-to-payer collaboration include: Successful implementation of a centralized hub-and-spoke model for secure payer-to-payer data exchange Reduced onboarding time and administrative complexity for participating payer organizations Capture of long-term cost savings and improved data accuracy via a platform that delivers multi-payer connectivity efficiencies and economies of scale Strengthened compliance readiness for CMS interoperability mandates effective January 2027 Enhanced continuity of care during member transitions between health plans through faster, standardized data sharing The KLAS Points of Light annual awards celebrate success stories achieved by payers, healthcare organizations, and healthcare IT companies whose partnerships focus on reducing costs and inefficiencies while striving to improve the patient experience. The awards will be presented at the KLAS K2 Collaborative Summit, May 20–22 in Salt Lake City. About Availity Availity is the trusted partner for organizations seeking to realize the greatest value from clinical, administrative, and financial data. Positioned at the nexus of provider, health plan, and consumer health information, Availity develops scalable, innovative solutions for healthcare data acquisition, standardization, transparency, automation, and exchange among health plans, providers, and technology partners. As one of the nation's largest health information networks, Availity facilitates billions of clinical, administrative, and financial transactions annually. Learn more at View source version on Contacts Media Contact: fuocoavaility@
Business Wire
15-05-2025
- Business
- Business Wire
mPulse Strengthens Market Position with Health Experience and Insights Leadership in Q1 2025
LOS ANGELES--(BUSINESS WIRE)--mPulse, a leading provider of Health Experience and Insights (HXI) technology, today announced strong Q1 financial performance while concurrently driving momentum focused on improving digital engagement capabilities with its HXI platform, which sees over four billion consumer touch points annually. The company launched key platform enhancements to better enable healthcare organizations to deploy meaningful consumer experiences and successfully advocated for improved healthcare regulations that benefit the broader healthcare community. As the healthcare landscape becomes increasingly digital and performance-driven, mPulse is actively prioritizing platform upgrades to better support its partners, which include 400+ healthcare organizations—including 40 of the country's 50 largest health plans. Decision Point Insights (DPI), mPulse's predictive analytics product, is now integrated with mPulse's omnichannel engagement so that predictive recommendations drive engagement program targeting, and the results of program outreach are visualized in the DPI user interface. This integration allows organizations to orchestrate programs by balancing the needs of consumers and measure program performance in one seamless solution. mPulse saw immediate interest in these updates with national and regional plans that focus on HEDIS, CAHPS, and HOS performance. These health plans leverage data-driven engagement to better design, launch, and optimize engagement strategies across populations at scale. The result is more coordinated and return on investment (ROI)-focused strategies that improve quality outcomes while delivering better experiences for members at every step of their journey. Building on recently launched enhancements, customers can now use self-service engagement tools to quickly develop and launch their own interactive omnichannel programs that incorporate mPulse's core natural language understanding (NLU) capabilities. These capabilities are coupled with mPulse's Activator programs that leverage behavioral science and personalization to address specific healthcare business and member needs. "mPulse is redefining how healthcare organizations engage their consumers and consistently innovating our offerings to ensure our customers have a 360° view of member interactions to streamline operations, reduce costs, save valuable time, and most importantly, improve consumer experience and outcomes,' said Bob Farrell, CEO of mPulse. 'We will continue to be a trusted partner, prioritizing the consumer experience through our HXI products while keeping a pulse on regulations impacting the industry to champion our customer's needs at a macro level.' The company continues its commitment to meeting the enterprise-level needs of the broader healthcare community, including successfully petitioning the Federal Communications Commission (FCC) to grant a limited waiver of forthcoming amendments to the TCPA rules around consent revocation for members earlier this year. Ahead of the ruling going into effect in April of 2026, mPulse is collaborating with leading healthcare organizations to understand their enterprise engagement and consent management strategies, and developing innovative solutions to support their enterprise goals. To see how mPulse can support your organization, visit our website here. About mPulse mPulse, a leader in digital solutions for the healthcare industry, is transforming consumer experiences to deliver better, more equitable health outcomes. By combining AI-powered analytics, omnichannel outreach and digital health navigation technology, mPulse creates personalized health journeys and provides advanced insights to power collaboration across the healthcare ecosystem. With over a decade of experience and 4 billion consumer touchpoints annually, mPulse is the trusted Health Experience and Insights (HXI) partner for over 400 healthcare organizations. To learn more, visit
