From a CMS perspective, incomplete follow-up is indistinguishable from incomplete care. Follow-up failures create gaps in the narrative of care. If a measure indicates successful management of a cardiac condition, there must be documented follow-up to support that claim. The practices that succeed in MIPS are not necessarily doing more, they are doing what they already do with greater precision, structure, and accountability. Because in cardiac measures, the weakest link is not diagnosis or treatment. It is whether you can prove that the care continued.

Gap closure reports are the strategic intelligence that separates high-performing ACOs from the rest. These reports identify patients who have missed critical preventive care, directly impacting HEDIS scores and shared savings. For ACOs, mastering gap closure is not just about improving quality metrics; it's about designing powerful incentive structures that motivate care coordination teams. Learn how to leverage technology, optimize workflows, and implement reward systems that drive performance, enhance patient outcomes, and achieve sustainable financial success in value-based care.