Gap Impact Calculator
Health plans and providers are working off claims-based gap lists that lag clinical reality by 60 to 90 days. On average, 30% of the gaps on those lists are already resolved — they just have not been coded yet. Enter your gap counts below to see what it would take to close these gaps before year-end.
⚙ Enter Open Gaps
CBP
Controlling High Blood Pressure
A1C
Hemoglobin A1c Control for Patients with Diabetes
CBP Open Gaps
0
A1C Open Gaps
0
Combined
0
CBP — Controlling High Blood Pressure
Gap Adjustment
Open Gaps Entered
0
Phantom Gaps due to Claims Adjudication Lag (10%)
−0
Phantom Gaps due to Resolved but Not Credited (17.5%)
−0
True CBP Gaps
0
A1C — Hemoglobin A1c Control
Gap Adjustment
Open Gaps Entered
0
Phantom Gaps due to Claims Adjudication Lag (10%)
−0
Phantom Gaps due to Resolved but Not Credited (18%)
−0
True A1C Gaps
0
Unique Members with Gaps
63% of Combined
Combined Gaps (CBP + A1C)
0
Overlap Adjustment (37% have both)
−0
Unique Members
0
Split into Two Buckets
Members with Engaged Providers
64% of Unique Members
0
0 × 64%
Members with Un-Engaged Providers
36% of Unique Members
0
0 × 36%
Intervention Needed
Intervention Needed — Engaged
31% of Members with Engaged Providers
0
0 × 31%
Intervention Needed — Un-Engaged
34% of Members with Un-Engaged Providers
0
0 × 34%
Case Study
A large community medical center serving 50,000 Medicaid lives was
leaving an estimated $8 to $9 million in performance-based revenue uncaptured annually. Within the first
90 days of a Valley Steer audit engagement -- with no EMR integration and no changes to physician
workflows -- the organization recovered over $2 million and improved two performance tiers on A1C and
blood pressure control. Their gap list was 30% wrong. Ours found it. Yours probably has the same
problem. Read the Full Case Study >
Recommended for Your Plan
Based on 0 unique members with open gaps, we offer a
$0
comprehensive quality measure audit
Ready to see what is in your charts? A 30-minute call is all it takes to determine whether an audit makes sense for your plan this year. No EMR integration required. No workflow changes for your providers.
Schedule Your Audit Consultation