Payer quality incentive programs like Healthfirst's HQIP reward clinics for closing care gaps — missed screenings, overdue preventive services, and unmet quality measures. The money is real: Lumexity has helped clinics capture over $500,000 in quality incentive revenue from a single payer program. Our Gaps in Care Analysis gives your team a real-time view of which patients have open gaps, exactly what's missing, and how to reach them — all inside eClinicalWorks. Software plus consulting. Not just data — a path to results.
Dashboard preview
Payers like Healthfirst run quality incentive programs — HQIP, HEDIS, QARR — that pay clinics for meeting specific quality measures: annual wellness visits completed, A1C screenings performed, cancer screenings up to date, depression screenings documented, immunizations administered.
Every unmet measure is a gap in care. Every gap is a missed incentive. And for clinics in New York and New Jersey participating in Healthfirst's network, the gap between what you could earn and what you actually receive can be hundreds of thousands of dollars per year.
The gap between what you could earn and what you actually receive can be hundreds of thousands of dollars per year.
The problem isn't clinical. Your providers know what care patients need. The problem is operational: there's no easy way to see which patients have open gaps, what specific screenings or services are missing, and who to contact first.
Most clinics discover their gaps after the measurement period closes — when payer scorecards arrive and the incentive is already lost. By then, the patients who needed a screening six months ago have moved on, and the revenue opportunity has expired.
Lumexity's Gaps in Care Analysis gives your clinic the visibility to act before the deadline — and the consulting support to improve the processes that create gaps in the first place.
See your entire patient population filtered by open care gaps — missed screenings, overdue preventive services, and unmet quality measures. Each patient shows exactly which measures are incomplete, what's needed to close the gap, and the incentive value tied to it. Updated in real time as your eCW data changes.
The dashboard maps your care gaps directly to Healthfirst's Quality Incentive Program measures — including HEDIS and QARR-aligned metrics for preventive care, chronic disease management, behavioral health, and immunizations. See your incentive exposure by measure, by provider, and across your entire practice. Built for Healthfirst in New York and New Jersey — and expandable to additional payers and states.
Every patient with an open gap includes the information your team needs to take action: phone number, address, last visit date, assigned provider, and a clear list of what's missing. Your front desk or care coordination team can start outreach immediately — no chart digging, no cross-referencing multiple systems.
Lumexity doesn't just show you the gaps — we help you close them. Our consulting engagement works alongside the dashboard to analyze your workflows, identify why gaps are occurring, and implement process changes that reduce gaps over time. This is how clinics go from reactive gap-chasing to systematic incentive capture. The $500K+ results come from this combination: data visibility plus operational change.
Lumexity connects to your eCW instance and maps your patient population against the specific quality measures in your payer incentive programs — starting with Healthfirst HQIP. Every open gap is identified, categorized, and tied to its incentive value.
Patients with open care gaps appear in a single view with what's missing, how to reach them, and the incentive at stake. Your front desk, care coordinators, and providers all have the information they need to act — before measurement periods close.
We don't stop at the dashboard. Lumexity consultants work with your practice to understand why gaps are occurring — scheduling bottlenecks, missed pre-visit planning, documentation issues, patient outreach gaps — and implement changes that reduce them structurally. The goal is fewer gaps next quarter, not just closed gaps this quarter.
Serving NY & NJ
Lumexity Gaps in Care Analysis is designed for practice administrators, medical directors, quality coordinators, and billing managers at clinics running eClinicalWorks in Healthfirst's provider network — serving Medicaid, Medicare Advantage, Essential Plan, and managed care members across New York City, Long Island, Westchester, and New Jersey.
If your clinic participates in Healthfirst's Quality Incentive Program (HQIP) and your incentive payouts are lower than expected — or if you don't have clear visibility into which measures you're missing — this is where you start.
We currently specialize in Healthfirst HQIP, but the platform and consulting model are designed to expand to additional payers, incentive programs, and states. If your practice works with other quality-focused payers, talk to us about building your gaps analysis around their specific measures.
Lumexity has helped clinics capture over $500,000 in Healthfirst quality incentive revenue through systematic gap identification, patient outreach, and process consulting.
Identify every open care gap across your patient population — missed screenings, overdue services, and unmet HEDIS measures — before the measurement period closes.
Reduce gaps structurally with consulting that addresses the root cause: scheduling, documentation, outreach, and pre-visit planning workflows.
Most gap-in-care tools show you a list. Lumexity shows you the list, tells you the dollar value behind each gap, gives your team the contact information to act, and then works alongside your practice to change the processes that caused the gaps.
The consulting engagement is what separates this from a report you look at once a quarter. We analyze your scheduling patterns, pre-visit workflows, documentation habits, and patient outreach cadence. We identify where gaps are being created — not just where they exist — and help your team implement changes that produce measurable results.
This is how clinics move from earning a fraction of their available incentives to capturing the full value their patient population represents.
Data connection is secure, read-only, and HIPAA-compliant. Consulting engagements are structured around your practice's timeline and goals.
We currently specialize in Healthfirst's Quality Incentive Program (HQIP), which includes HEDIS and QARR-aligned measures for clinics in New York and New Jersey. The platform is designed to expand to additional payers and incentive programs — if your practice participates in other quality programs, contact us to discuss customization.
The dashboard tracks gaps aligned to payer quality measures — including annual wellness visits, cancer screenings (breast, cervical, colorectal), diabetes management (A1C, eye exams, kidney screening), depression screenings, immunizations, blood pressure control, medication adherence, and behavioral health follow-ups. The specific measures depend on the payer incentive program your practice participates in.
eClinicalWorks offers population-level HEDIS reporting, but it doesn't map gaps to specific payer incentive programs, calculate your financial exposure per gap, or provide patient-level contact views for outreach. Lumexity layers payer-specific incentive logic on top of your eCW data and pairs it with consulting to help your practice actually close the gaps — not just see them.
Our consultants analyze your scheduling workflows, pre-visit planning processes, documentation practices, and patient outreach patterns to identify why gaps are occurring. We then work with your team to implement changes — adjusted scheduling templates, outreach protocols, provider huddle checklists, and documentation improvements — that reduce gaps structurally, not just reactively.
By combining real-time gap visibility with operational process changes. The dashboard identified which patients had open gaps and which measures carried the highest incentive value. The consulting engagement changed how the clinic scheduled, prepped for visits, and conducted outreach. Together, this shifted the practice from reactive gap-chasing after scorecards arrived to proactive gap closure before measurement periods ended — capturing incentive revenue that had previously been lost.
Yes. While our deepest expertise is with Healthfirst HQIP in New York and New Jersey, the platform and consulting model are designed to adapt to other payers and states. If your practice participates in quality incentive programs from other managed care organizations, we can customize the analysis for your specific measures and incentive structure.
See exactly which quality measures your clinic is missing, how much incentive revenue is at stake, and what your team needs to do to capture it — before the measurement period closes.
