What is HEDIS Consulting
When clinics miss HEDIS targets, they are not just losing quality scores, they are leaving real money on the table in the form of quality bonus payouts, shared savings, and pay for performance incentives.
The problem is rarely a lack of care, it is a lack of time. A physician has 15 minutes to diagnose and prescribe, not 45 minutes to talk through why a patient isn't taking their statins, filling their A1c lab slips, or showing up for a mammogram.
HEDIS Consulting, led by Dr. Gabriel Basbus, MD, works alongside CB Health and Wellness's coaching team to close exactly those gaps, so the clinical team stays focused on care, not chasing paperwork.
My consulting services help practices:
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Improve HEDIS, STARS, and QARR quality measure performance
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Identify and close preventive and chronic care gaps
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Prepare for current and future value based reimbursement models
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Reduce administrative burden on providers and clinical staff
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Transform clinical and operational data into actionable insights
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Increase performance on health plan quality incentive programs
How it works
1.
Identify and stratify your non compliant patients.
We start by reviewing your gap in care report and identifying patients missing high value measures, diabetes control, blood pressure control, cancer screenings, and statin adherence.
2.
Targeted coaching outreach.
Our coaches contact non compliant patients directly, using motivational interviewing to understand the real barrier, cost, transportation, health literacy, or hesitancy, rather than leaving another voicemail reminder.
3.
Schedule and close the gap.
Coaches schedule the lab visit, order an at home screening kit, or arrange the appointment, and update your gap closure fields directly.
4.
Reconcile and report.
Closed gaps are properly documented and submitted so they count toward your measurement year and incentive payout.
Funding this without adding to your budget
We know budget is usually the first concern, so here is how clinics typically fund this work.
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Start with a focused pilot. A 90 day pilot targeting your highest value, highest risk non compliant patients lets you see results before any larger commitment.
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HMO quality improvement funds. Many health plans offer infrastructure or gap closure grants to medical groups working to improve their quality metrics, we can help you identify what your plan offers.
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Billable coaching activity. Certain coaching and care management activities can be billed directly when supervised by a qualified provider, including non physician self management education and chronic care management codes.
Where we support your quality goals
Preventive care and screening measures
Diabetes and blood pressure control
Readmission reduction
Support for BCS, COL, and WCV completion through patient outreach
Coaching aligned with HBD and CBP measures
Chronic disease coaching that helps reduce avoidable readmissions across your patient population.
Weight assessment and counseling
Supporting WCC and BMI focused goals with GLP-1 and WFPB coaching
Why CB Health and Wellness
CB Health and Wellness is physician led on both sides, founded by Dr. Cecilia Basbus, MD, CHC, with hospital and clinic partnerships managed by Dr. Gabriel Basbus, MD. Our bilingual coaching team, fluent in English and Spanish, delivers virtual coaching nationwide, reaching your patients wherever they are, backed by a HIPAA compliant platform with reporting your team can use directly.
Working to close HEDIS gaps or reduce preventable readmissions this year