Case Study: CareFirst Community Health Plan District of Columbia achieves faster chart retrieval and higher HEDIS Star ratings with eClinicalWorks' healow Insights

Better Data Improves Care, Saves Money

CareFirst Community Health Plan District of Columbia faced a time‑consuming, manual “chart‑pull” process to collect medical records from many providers — a task made harder by disparate systems and COVID‑19 restrictions — while trying to shift toward value‑based care and meet HEDIS reporting needs. Their challenge was to improve efficiency, reduce resource use for record abstraction, and raise quality scores for well‑child counseling measures.

They deployed healow Insights, a cloud‑based, encrypted service that automates secure sharing of clinical records between providers and payers. CareFirst obtained more than 1,500 patient records within 48 hours without on‑site visits, reallocated savings to reporting, and increased record capture for key measures (BMI +17.4%, Nutrition +34.3%, Physical Activity +30.1%), improving NCQA Star ratings (BMI 1→3; Nutrition 1→2; Physical Activity 1→2).

CareFirst Community Health Plan District of Columbia

Belinda Zhang

Chief Quality Officer