TriZetto Provider Care Gaps

Traditional gaps in care workflows rely on chart chasing, spreadsheets and payer portals that slow care delivery and increase administrative cost. TriZetto® Provider Care Gaps changes this by delivering real‑time, FHIR‑based gap intelligence to providers at the point of care. The solution uses DEQM standards to surface open gaps, data requirements and evidence pathways that support automated closure. Providers see accurate, prospective gap information, understand the logic behind each gap and submit structured data without leaving the EHR.

As part of the TriZetto’s interoperability platforms, the solution supports secure routing, interoperability and alignment with TriZetto’s NCQA-certified HEDIS engine, ClaimSphere. Payers and providers gain a shared, trusted view of quality performance while reducing friction and manual work. The result is faster gap closure, more efficient workflows and improved outcomes.

With TriZetto Provider Care Gaps providers can:

• Identify open gaps directly in the EHR with trusted, standards-based information that helps care teams take immediate action during the visit.
• Reduce chart chasing through automated evidence submission and computable reporting that replaces portals and manual workflows.
• Improve quality scores and shared savings with proactive, prospective gap management supported by FHIR and DEQM.