Credo Health published a new report, “Closing the Data to Action Gap in Value Based Care,” revealing how missing access to patient health records costs the U.S. healthcare system roughly eight billion dollars each year and highlighting the potential for AI to close this gap. The report combines survey data from over 500 physicians and care team members with insights from a 150-clinician point-of-care beta program and real-world pilot studies to explore what drives actionable outcomes in clinical workflows, particularly for Medicare patients who receive care from multiple providers across multiple settings.
Health Technology Insights: Nemluvio Shows Rapid Itch Relief and Sleep Benefits
“When the AI can show its work, trust and usability at the point of care increase and translate into meaningful clinical actions that can ultimately save lives,” said Joshua Solot, MD, Consulting Physician at Credo Health.
Credo’s analysis estimates that incomplete medical records cause around eight billion dollars annually in operational waste, including lost specialist capacity and disrupted primary care. The report also highlights the human impact, linking missing clinical context to approximately 20,000 deaths and 1.5 million delayed or missed diagnoses each year, as well as a potential one thousand one hundred dollars per Medicare patient in missed risk-based revenue tied to documentation gaps.
“Our mission at Credo Health is to help doctors perfectly diagnose and treat every patient,” said Carm Huntress, CEO of Credo Health. “We observed that value-based care performance improved when clinicians had decision-ready context at the point of care. In our beta, physicians used an AI copilot to access more complete clinical histories. Credo’s AI surfaced clinically supported care opportunities, such as suspected HCC conditions for Medicare risk adjustment, making it much easier for clinicians to review records, extract insights, and take action.”
Despite significant investments in interoperability, the report shows that record completeness and usability remain inconsistent in everyday clinical workflows. Physicians often must navigate scattered notes, PDFs, lab results, consult letters, and external packets to gather the information they need. This problem is especially pronounced for Medicare populations managing multiple chronic conditions.
“Physicians have always used data to form and test hypotheses, asking layered questions and hunting for evidence to validate assumptions,” said Avishaan Singh Sethi, CTO of Credo Health. “More data and more technology should make this easier, but often it has not. Critical records are scattered, leaving clinicians less confident in their decisions. In our pilot, closing the data-to-action gap required pairing physicians with AI engineers so the AI could assemble and structure data, generate clinically relevant insights, and answer the complex questions doctors need to act confidently.”
Health Technology Insights: Form Health Offers Clear, Predictable GLP-1 Coverage for Employers
Pilot results underscore the value of combining completeness with evidence-backed insights. In a cohort of 500 patients reviewed by two solution providers, Credo’s AI model identified 2.1 times more clinically accepted new HCC suspects than a competing solution. Physicians accepted 425 net-new suspects from Credo, representing a 77 percent acceptance rate, compared with 200 net-new suspects from the competitor at a 66 percent acceptance rate. The success was attributed to Credo’s ability to present source-verifiable clinical opportunities that clinicians could quickly trust and act on.
“AI models become significantly more effective when trained to reason like physicians through a patient record,” said Joshua Solot, MD. “When the AI demonstrates its reasoning, trust and usability increase at the point of care, allowing clinicians to take meaningful action that can save lives.”
The report emphasizes that better data only matters if it reduces clinician workload and earns trust. Clinicians already operate at full capacity, and reviewing incomplete patient histories adds to burnout. Credo’s findings suggest that AI in value-based care must be designed not just for accuracy but also to streamline decision-making and integrate seamlessly into clinical workflows.
Key takeaways include the importance of assembling longitudinal records across multiple sources, delivering clinically trained AI that provides source-cited insights, producing outputs that can support documentation and risk workflows, and surfacing trends and gaps in patient records. The report demonstrates that closing the data-to-action gap enables more confident, timely, and effective decision-making at the point of care.
Health Technology Insights: FDA Approves Exdensur (Depemokimab) for Severe Asthma
To participate in our interviews, please write to our HealthTech Media Room at info@intentamplify.com
