Closing the Last Mile of Medicare Quality: From Care Gaps to Smarter Action
Medicare Advantage plans excel at identifying care gaps, but closing the last mile—getting members to completed, documented care—remains an elusive operational hurdle. As quality measures evolve, how can health plans move beyond broad segmentation to deliver the right next action for every member?
In this Bright Spots in Healthcare session, MA and quality leaders will discuss where AI scale meets human intervention, how cross-functional teams can align workflows, and what it takes to measure true quality impact. Attendees will gain practical insights into leveraging existing data and technology to drive verified care completion efficiently.
The conversation will focus on:
- How plans are moving beyond broad segmentation to identify the right next action for each member
- Where AI can create scale and where human intervention still makes the difference
- How quality, care management, provider, and engagement efforts can work together more effectively
- What it takes to adapt outreach based on member response, barriers and changing needs
- How plans are measuring success beyond outreach and engagement, with greater focus on verified care completion and quality impact
For health plan leaders deciding where to invest next, this discussion will focus on a practical question: how do you use the data, technology, and programs already in place to make each next action smarter while getting more members to the care they actually need?