Why Chasing Isn’t Closing: The Real Cost of Manual Gap Closure

In quality management, there's a critical distinction that organizations often overlook: activity doesn't equal achievement. Nowhere is this more evident than in the exhausting cycle of manual gap closure, where care teams spend countless hours chasing patients for HEDIS^® measures and Stars ratings compliance, yet gaps remain stubbornly open.

The reality is stark. Manual gap closure processes consume enormous resources while delivering diminishing returns. Care coordinators make call after call, often reaching voicemails or disconnected numbers. Medical assistants frantically schedule appointments in the final weeks of the measurement year. Providers squeeze in measure-related services during visits meant for other concerns. Everyone is busy, yet closure rates plateau far below target.

The Hidden Costs of Manual Processes

The true cost of manual gap closure extends far beyond wasted time. Staff burnout runs rampant when teams feel like they're perpetually playing catch-up. Experienced care coordinators, exhausted by the endless grind, leave for less stressful positions. The constant pressure to "close gaps" creates an environment where quality improvement feels like an administrative burden rather than meaningful patient care.

Patient experience suffers too. Members receive multiple outreach attempts like calls, letters, and portal messages, that feel impersonal and transactional. When patients do respond, they're often scheduled for appointments that don't align with their actual health needs, just to check a HEDIS box. This approach erodes trust and damages the patient-provider relationship that underpins genuine quality improvement.

Financial implications compound quickly. Consider the fully-loaded cost of a care coordinator spending 20 hours weekly on manual outreach with a 15% success rate. Add the opportunity cost of what those hours could have accomplished with better tools and targeting. Factor in the revenue loss from missed bonus payments when gaps don't close despite heroic efforts. The numbers become staggering.

Why Manual Methods Fail

Manual gap closure operates on outdated assumptions. It treats all gaps as equally urgent and all patients as equally reachable through the same channels. It relies on static lists that become obsolete the moment they're generated. It lacks the sophistication to predict which patients are most likely to respond to which interventions.

Perhaps most critically, manual processes can't scale. As value-based care arrangements expand and quality measures multiply, the gap closure workload grows exponentially. Throwing more staff at the problem isn't sustainable, and it doesn't work. Organizations need fundamentally different approaches.

The Path Forward

Effective gap closure requires intelligent automation, predictive analytics, and strategic resource allocation. Technology can identify which patients have gaps, predict their likelihood of closure, determine optimal outreach timing and channels, and prioritize interventions based on expected impact.

This doesn't mean removing the human element, we amplify it. When technology handles identification, prioritization, and routine communication, care teams can focus on high-value activities: having meaningful conversations with patients, addressing barriers to care, coordinating complex interventions, and building relationships that drive long-term engagement.

The organizations achieving superior HEDIS and Stars performance aren't the ones working hardest at manual processes. They're the ones working smartest, leveraging technology to target efforts where they'll make the greatest difference.

The question isn't whether your team is busy chasing gaps. It's whether that activity is actually closing them and at what cost. Until organizations move beyond manual processes, they'll continue expending maximum effort for minimal results, wondering why performance never matches the work invested.

Transforming Gap Closure

UST HealthProof's Quality Improvement solutions address these challenges head-on by combining advanced analytics with strategic expertise. Quality360^™ moves organizations beyond the chase by providing predictive insights that identify not just which gaps exist, but which ones are most likely to close and which interventions will be most effective. The platform integrates data across multiple sources to create a comprehensive view of member populations, enabling care teams to work with precision rather than hope. 

Organizations can automate routine outreach, personalize member engagement based on behavioral patterns, and allocate resources strategically to maximize Stars and HEDIS performance. The result is a transformation from exhausting manual pursuit to intelligent, sustainable gap closure that improves both outcomes and team morale.