Give your providers a reason to close gaps before it's a scramble
↑ 40% more evidence submitted
Show provider incentives next to open gaps and lift evidence submissions by up to 40%.*
↓ 77% less manual review
AI chart abstraction surfaces the clinical evidence for gap closure, cutting manual chart review by up to 77%.*
All lines of business
Run Medicare Advantage, Medicaid, Commercial, and ACA from one configuration layer, with rules set per line of business.
*Customer results shown, outcomes may vary based on configuration and program design.
A quality program that closes gaps as they surface
Care Gap Manager gives payer quality teams a program that reaches every provider group year-round. Providers see current gaps pulled directly from your quality and risk engines, with up-to-date incentive earnings, and what is still open to earn. Evidence is submitted by the practice back to the plan for approval.
Actionable gap closure and evidence in one system
Outreach timed to current gap status
Automated weekly summaries and rejection alerts keep providers current on their gaps, earnings, and remaining opportunity. Omni-channel outreach targets non-responders via coordinated email, in-app, and phone tied to current gap status rather than a fixed calendar.
A submission path your team validates
Each submission enters the plan’s validator queue after the provider has uploaded the charts, individually or in bulk. Any rejections are returned to the provider portal with a reason code and resubmission steps.
Incentive earnings next to open gaps
Year-to-date incentive earnings, remaining opportunity, and closure progress against targets visible to providers in the same view as their open gaps. One click from any measure surfaces the member list behind it.
Gap rules that fit your program
Configure gaps based on plan needs. Closure instructions, data fields captured, and validation workflows can all be uniquely defined. Limit what gaps can be closed and what exclusions are supported.
Roster management stays current
Replace the phone calls and spreadsheet chaos that create roster errors. Attributed member rosters updated from the plan's eligibility data, with provider-facing, one-click de-attribution requests, route through a defined review workflow.
Spot friction before submissions drop
Dashboards and automated reports trend user logins, submissions, acceptances, rejections, and outreach by group and user. Practice-level satisfaction scores flag engagement early enough for quality teams to step in.
How it Works
How Care Gap Manager software enables year-round gap closure
Configure measures and rules
Reveleer partners with the plan to set up measures, incentive rules, and outreach.
Providers see gaps and earnings
Provider groups open one portal to see current gaps, earnings, and opportunity.
Live performance insights
Always-on care gap dashboards show provider progress at a glance.
Submit and plan validates
Providers submit evidence; reviewers approve or reject with a reason code.
Quality, network, and finance leaders work from the same view
For quality and Stars leaders
Continuous gap refresh gives quality and stars leaders the foresight to project where year-end lands while the year is still open; tracking closure across every contract and line of business in one view and focusing efforts on the contracts closest to a cut point.
For health plan network leaders
Your health plan’s provider network and value-based care teams give every contracted group a single view of its current gaps and the incentive dollars tied to closing them. Outreach follows each group’s submission activity, so the program reaches the medium and small independent practices that other portals leave behind.
For health plan finance executives
Finance leaders see incentive payout status against current gap closure at the provider group level, so the link between spend and Stars performance sits on one dashboard. Every submission also carries a timestamped record an auditor can trace straight from the system.
For quality and stars leaders
Continuous gap refresh gives quality and stars leaders the foresight to project where year-end lands while the year is still open; tracking closure across every contract and line of business in one view and focusing efforts on the contracts closest to a cut point.
For health plan network leaders
Your health plan’s provider network and value-based care teams give every contracted group a single view of it’s current gaps and the incentive dollars tied to closing them. Outreach follows each group’s submission activity, so the program reaches the medium and small independent practices that other portals leave behind.
For health plan finance executives
Finance leaders see incentive payout status against current gap closure at the provider group level, so the link between spend and Stars performance sits on one dashboard. Every submission also carries a timestamped record an auditor can trace straight from the system.
Connected gap closure vs manual, disconnected tracking
| Connected, year-round program | Manual, disconnected spreadsheets | |
|---|---|---|
| Gap data currency | Year-round care gap program Refreshes continuously from the plan's HEDIS® and quality engines | Seasonal, fragmented programs Static lists exported to spreadsheets that go stale |
| Incentive visibility | Year-round care gap program Year-to-date earnings and remaining opportunity next to each gap | Seasonal, fragmented programs Incentive totals tracked in spreadsheets providers cannot verify |
| Provider engagement | Year-round care gap program Distributed, timely outreach matched to each group's current submission status | Seasonal, fragmented programs Ad hoc outreach with limited or no shared view of current status |
| Evidence trail | Year-round care gap program Timestamped, attributed record on every submission | Seasonal, fragmented programs Reassembled from email and spreadsheets at audit |
| Staffing pattern | Year-round care gap program Steady workload the quality team configures once | Seasonal, fragmented programs Staff time lost piecing together reports across disconnected sources |
| Star Ratings trajectory | Year-round care gap program Projected while the measurement year is still open | Seasonal, fragmented programs Visible only after data is compiled from multiple sources |
HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).
See open gaps and earned incentives, in the same view
See how health plans use Care Gap Manager for year-round care gap closure across every provider group. Open gaps, earned incentives, and validated evidence come together in one provider experience, and your team keeps the plan-side controls behind it.
- Refresh gap lists continuously, so providers trust the data
- Show year-to-date incentive earnings next to open gaps
- Validate and approve evidence submissions
- Engage providers with clear, actionable omnichannel methods
- Track closure progress by group before HEDIS season deadlines
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Care gap management questions
What is care gap management software for health plans?
Care gap management software is how a health plan closes quality and risk gaps across the year. Care Gap Manager runs it as a continuous, plan-administered program: provider groups see current gaps, incentive earnings, and a submission path in one place, and validated evidence flows back to the plan's quality and risk workflows.
How does year-round care gap software improve Star Ratings performance?
Prospective, year-round care gap closure spreads the work across all four quarters instead of the Q4 crush. Plans close a higher share of gaps in Q1 and Q2, reduce the volume that piles up before the submission window compresses, and can see where the Star Ratings trajectory will land while the measurement year is still open.
How do providers see incentives next to their HEDIS and Stars quality gaps in care?
Provider groups use Care Gap Manager to access year-to-date incentive earnings, remaining opportunity, and closure progress in the same session as their open HEDIS gaps in care. Groups that see what they earn beside each gap submit evidence at higher rates than groups given incentive information separately or quarterly.
Does Care Gap Manager need an EHR integration to reach provider groups?
Provider groups don't need their own EHR integration to see and close gaps. Your plan handles setup and configuration with Reveleer. Care Gap Manager reaches every provider group through a browser-based portal, which is how it reaches the medium and small independent groups other approaches miss.
How is Care Gap Manager different from other care gap software?
Other care gap software either stops at analytics or lives inside the EHR, where it reaches only the groups already integrated. Care Gap Manager is a plan-administered program that reaches the whole network through a browser. It combines the provider portal, real-time incentive visibility, coordinated provider engagement, and validated evidence submission across Medicare Advantage, Medicaid, Commercial, and ACA.
Reach every provider group in your network
Care Gap Manager runs gap refresh, incentive visibility, evidence validation, and provider outreach as one continuous program the health plan controls. It extends across every contracted group, including the medium and small independent practices that sit outside an EHR integration, so your network works from the same consistent, up-to-date view of gaps and earned incentives.
