Care Gap Closure

Care gap closure refers to identifying members who are due for a preventive screening, a chronic-condition check-in, or a follow-up they never completed, and getting that visit done before the gap turns into an escalation. In payor and health-plan contexts, this is formally a HEDIS and CMS Star-ratings function, plans are scored in part on how effectively they close known gaps in their member population, which is part of why value-based care contracts increasingly tie payment to gap-closure performance rather than raw visit volume.

For self-funded employers, the mechanism is simpler but the stakes are just as concrete: 50% of unmanaged chronic conditions will ultimately escalate to emergencies, and the emergency department is roughly 12 times more expensive than a primary-care or on-site setting for the same underlying condition. A missed A1C recheck, a skipped blood pressure follow-up, or a medication-adherence check that never happens isn't a small administrative miss, it's the exact point in the claims lifecycle where a low-cost visit either happens or doesn't, and if it doesn't, the condition frequently resurfaces later as a much larger claim.

The structural reason care gaps persist even when they're covered by insurance is access friction, not awareness: an employee generally knows they're overdue for a follow-up, but scheduling it means finding an appointment slot, arranging time off, and often driving somewhere during working hours. The OnMed CareStation™ removes each of those steps by offering a walk-in, no-appointment path to the exact visit an employee has been putting off. 42% of Employer-vertical CareStation users present with a chronic condition, and because there's no scheduling required, a gap-closure visit can happen on a break rather than waiting for a day off.

This also connects directly to preventive care compliance under HDHP plan design: most preventive services are covered pre-deductible under IRS safe harbor rules regardless of an employee's deductible status, meaning the cost barrier to closing a care gap is frequently already removed, what's left is the access barrier, which is precisely what walk-in, on-site care is built to solve.