Case Study: Texas 65,000‑member Medicare Advantage health plan achieves $24M annual revenue uplift and 38% chronic‑care gap closures with SCIO Health Analytics' SCIOClarity™

Texas Health Plan Provider - Customer Case Study

Texas Health Plan Provider, a 65,000+ member Medicare Advantage health plan in Texas, needed to improve risk scores and optimize revenue by engaging providers, delivering consistent actionable information, identifying members with chronic gaps in care, and targeting low‑performing physicians. They engaged SCIO Health Analytics and its SCIOClarity™ Risk Adjustment & Quality Analytics to address these challenges.

SCIO Health Analytics implemented a three‑pronged approach: deployed SCIOClarity™ to high‑volume provider groups for full data transparency and suspect lists; generated monthly health assessment forms for lower‑volume providers and targeted members with chronic conditions; and used SCIOClarity™ reporting to identify and educate outlier physicians. In one year the plan closed 38% of chronic‑condition gaps and achieved an increased annual revenue potential of $24 million.