Health systems are using AI to rapidly improve Medicare Advantage Stars and HEDIS® performance—shifting quality from retrospective reporting to real-time, in-workflow action.

This session examines how AI-enabled quality gap closure is transforming quality improvements quality from retrospective reporting to proactive, in-workflow execution, with real-world examples from organizations including Guidehealth and leading systems such as Emory Healthcare. Attendees will see how these approaches have delivered measurable gains, including rapid improvement from 1-Star to 4-Star performance on blood pressure control measures.

Key use cases include:

• AI voice agents enabling accurate, scalable home blood pressure reporting
• Blended AI + human engagement models improving medication adherence through 90-day therapy conversion across hypertension, diabetes, and hyperlipidemia

The session also addresses critical design and deployment considerations, including regulatory requirements, workflow integration, and the roles of clinicians, pharmacists, and quality and operations teams.

Designed for healthcare executives and population health leaders, this session equips attendees with practical strategies to accelerate Stars and HEDIS performance, reduce administrative burden, and improve outcomes and experience for Medicare Advantage beneficiaries.