Case Study: Leading Healthcare Services Company achieves 80% coding-gap closure and improved risk adjustment & Star Ratings with Innovaccer

How can MA Plans Transform Risk Adjustment and Star Ratings Performance with FHIR-enabled Data Activation Platform

Leading Healthcare Services Company faced slow, manual Clinical Documentation Improvement (CDI) processes—alerts were delivered on paper and providers often waited up to two weeks for feedback—making it difficult to identify and close coding and quality gaps for Medicare Advantage members. To digitize provider engagement and integrate with provider EHRs, the customer partnered with Innovaccer and adopted Innovaccer’s FHIR-enabled Data Activation Platform and the InNote point-of-care alerts/insights solution.

Innovaccer implemented in-workflow, bidirectional FHIR APIs (InAPI) and InNote to surface CDI alerts and contextual coding guidance directly in the EHR, cutting turnaround from roughly two weeks to a couple of days. The deployment flagged 100% of gaps at the point of care, enabled providers to close 80% of gaps, reduced chart retrieval time by 80%, surfaced 400+ supplemental codes, found 100% additional data for attributed members, and achieved 99%+ API uptime—delivering substantial dollar savings in just months for the Leading Healthcare Services Company.