Case Study: a leading national health plan improves HEDIS gap closure with EXL Health's GAPS solution

Transforming HEDIS (Healthcare Effectiveness Data and Information) through EXL Health’s HEDIS Gap Allocation Prioritization Solution

EXL worked with a leading national health plan that wanted to improve its HEDIS process, increase gap closure rates, reduce average handling times, and handle more cases per day, while also boosting star ratings for lower-performing plans and protecting ratings for stronger ones. To support this, the health plan turned to EXL Health and its HEDIS Gap Allocation Prioritization Solution (GAPS).

EXL implemented GAPS, an integrated workflow solution for payer organizations with record stratification, prioritization, provider outreach, indexing, abstraction, and gaps-in-care closure capabilities. The platform helped streamline work allocation, improve provider outreach and education, and support data-driven fax tracking and real-time recommendations. As a result, EXL delivered a 12% improvement in gap closure rates, a 54% improvement in cases handled per day, and a 36% reduction in average handling time.