HCC Gap Closure & RAF

Click any KPI, stage, or HCC row to drill into member-level detail.
Opportunities closed MTD
+4.5%
1,289
of 1,495 identified this month
Avg days to close
+3.1%
38 days
Target: ≤ 30 days79% to goal
Opportunity lifecycle pipeline
Every actionable opportunity from identification through closure — current open volume by stage
65% conversion
71% conversion
65% conversion
85% conversion
84% conversion
Total capture rate21.3%
Volume still in pipeline3,008 opportunities
On-time closure rate vs target
Current year vs prior year
Identified vs closed vs on time
Monthly volume
Open opportunity aging
3,325 open · 318 past due
0-30 days
1,482
31-60 days
921
61-90 days
604
90+ days
318
Top closure blockers
Where opportunities stall, and what it costs in RAF
BlockerStageOpportunitiesRAF held
Member unreachable after 3 attemptsOutreach4120.084
Visit scheduled beyond measurement yearScheduled2870.061
Condition not clinically supported in noteDocumented2140.048
Specialist-only diagnosis, no PCP confirmationDocumented1680.037
Encounter rejected by payor editSubmitted960.021
Actionable opportunities by HCC category
Recapture and suspecting combined · click a row for member-level detail
HCCConditionOpenClosed YTDRAF weightRAF at stakeClosure
HCC 19Diabetes without complication4866120.10450.5
56%
HCC 18Diabetes with chronic complications3124050.30294.2
56%
HCC 111Chronic obstructive pulmonary disease2743380.32889.9
55%
HCC 85Congestive heart failure2413660.33179.8
60%
HCC 138Chronic kidney disease, stage 41581870.28945.7
54%
HCC 12Breast, prostate, and other cancers1211440.15018.1
54%