Closing Gaps in Care Toolkit
Addressing gaps in care is an important opportunity to improve patient care and a practice’s quality metrics. Creating an outreach plan to reach specific patient populations based on their conditions can make a gap closure plan more manageable and successful.
Closing gaps in care can lead to a better managed patient population, helping to catch potentially life-threatening illnesses in patients, coordinate needed care and also improve opportunties for more incentive dollars from payers.
A gaps in care plan should include:
- HEDIS gaps in care reports generated through a practice’s electronic medical record and through TPA’s disease registry, Wellcentive.
- running reports using metrics on tracking tool (provided by your practice resource team (PRT) member)
- reminder letters to patients listing screenings and tests that are due; follow up with patients via phone calls, texts, emails
- utilizing patient portals for additional reminders
- a copy of worked reports and lists in your patient centered medical home binder, along with the tracking tool to go over at PRT visit
Resources for closing gaps in care
Patient education materials (various health topics, including cancer screenings, diabetes prevention and management, blood pressure management and more)
Engaging patients in telemedicine poster
Tips for closing gaps in care poster
Social media graphics
Click here for social media graphics that can be used to promote telemedicine, screenings and other health/wellness topics to patients.