Value-based care

Identifying the care gap is the easy part. Closing it is what determines your score.

Identifying the care gap is the easy part. Closing it is what determines your score.

Edwin converts your open quality measures into personalized patient missions that guide each member to completion, through the channel they actually use, with every closed gap verified back to your registry.

Trusted by
Mass General Brigham
Harvard T.H. Chan School of Public Health
Novo Nordisk
Ro
Ideal
Mass General Brigham
Harvard T.H. Chan School of Public Health
Novo Nordisk
Ro
Ideal

Your analytics are excellent. Your gap closure rate isn't.

Value-based care organizations have invested heavily in data. Registries identify open HEDIS measures, flag HCC recapture opportunities, and surface exactly which patients need outreach. But the outreach model hasn't kept pace with the analytics. A list of 200 members who need a diabetic eye exam doesn't become 200 completed exams without a scalable way to reach, guide, and verify each one. The gap between identified and closed is where quality scores are won or lost.

Where VBC excels
Identifying the gap
HEDIS measure tracking
HCC recapture registries
Risk stratification
Care gap analytics
Where execution breaks down
Closing the gap
Manual outreach at scale
Low member response rates
No verified completion data
Staff capacity limits

The execution layer your registry is missing

Every gap becomes a patient mission
Edwin converts your open quality measures into step-by-step patient missions, personalized to each member's situation. Not a blast message. A guided, individual journey from gap identified to gap closed, in their language, through their channel.
Verified closure, not just outreach
Edwin does not track attempts. It verifies completions. Every closed gap flows back to your registry as confirmed data so your HEDIS and STAR submissions reflect what members actually did, not what your team tried to get them to do.
Works inside your existing stack
Edwin connects to your care management platform. Your workflows stay the same. Edwin sits downstream of what you already have, closing the gap between your data and your members' actions.
How it works

From open gap in the registry to verified completion

Three steps. Your registry and workflows stay exactly as they are. Edwin runs in between your data and your members.

01
Your registry surfaces an open measure
Edwin picks it up and converts it into a personalized patient mission, adapted to the member's language, channel, and specific gap type. Each measure becomes a different mission built for that member's situation. No manual work for your care team.
02
The member gets a guided path to completion
Clear, step-by-step missions arrive through text, voice, or app. Edwin walks each member through scheduling, prep, and what to expect for that specific measure. Reminders adapt if they go quiet. No voicemails. No letters. A conversation that actually moves people.
03
Verified closure flows back to your registry
Completed gaps are confirmed and sent back to your system. Your HEDIS and STAR data reflects actual closed measures. Your team focuses on the members who still need help, not on chasing everyone on the list.
The closure layer

Gap registries tell you what's open. Edwin tells you what's closed.

Value-based care organizations are data-rich and execution-constrained. The analytics are sophisticated. The outreach is manual and underscaled. A care manager with a list of 200 members who each need a diabetic eye exam, a colorectal cancer screening, or an annual wellness visit can only make so many calls in a measurement year. Most of those gaps stay open. Your quality scores reflect that.

Edwin scales the execution layer without scaling headcount. Every open measure in your registry becomes a personalized member mission delivered through text, voice, or app. Members are guided through exactly what they need to do for that specific gap, in their language, at the right moment in your measurement calendar.

The result shows up in your scores. Verified gap closures. Documented completions your registry can actually use. And a quality program that finally keeps pace with the sophistication of your analytics.

Value-Based Care

Turn your gap registry into a gap closure engine.

Turn your gap registry into a gap closure engine.

Edwin converts your open quality measures into verified patient completions that improve your HEDIS, STAR, and HCC performance. Book a demo to see it in your program.