Organizations honored with 2025 KLAS Points of Light Award, with athenahealth uncovering nearly 10 care and diagnosis gaps per Humana member among Your Health’s patient population
athenahealth, a leading provider of network-enabled software and services for healthcare practices nationwide, in collaboration with key partners Humana and Your Health, a South Carolina-based primary care practice, have received a 2025 Points of Light Award from KLAS. This recognition is for the case study, “Closing Care Gaps & Reducing the Administrative Burden Through Improved Data Sharing.” This recognition highlights how integrating timely and relevant information directly into the clinical workflow can help improve health outcomes for patients.
“Facilitating collaboration between payer and provider organizations to improve care and eliminate administrative tasks is how we can deliver care experience that patients expect and deserve,” said Sam Lambson, VP of Product Management, Data and Ecosystem.
“At Your Health, our clinicians focus on delivering care that’s preventative, personalized, and high-quality. This requires our staff to track patients and their health beyond the clinic and identify and address care gaps before they escalate to more serious or costly conditions,” said Will Stillinger, chief operating officer, Your Health. “Humana and athenahealth have established an open and seamless information exchange that helps us deliver better care while eliminating administrative burden and costly interventions. We are excited by the opportunity for future care intervention pathways based on factors like Social Determinants of Health.”
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To accomplish this real-time data exchange, Humana and athenahealth partnered to implement athenaPayer’s Care and Diagnosis Gaps solutions to identify and surface care and diagnosis gaps among Humana’s Medicare Advantage members. Utilizing athenahealth’s cloud-based, single instance platform, Your Health clinicians can now see relevant patient information ahead of visits, address identified gaps during the visit, and document diagnoses and care plans directly within athenaOne. Leveraging Da Vinci APIs, athenahealth automatically sends validated data back to Humana to appropriately document and report on the quality of care they provide to members.
As the case study reports, athenahealth has uncovered an average of 4.8 additional care gaps and 4.7 additional diagnosis gaps per member among Humana’s Medicare Advantage population, and Humana has been able to close 35% of its CMS Star gaps. Your Health clinicians now spend less time identifying care gaps with limited information, improving care while reducing documentation time.
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“By investing in improving preventive care and management of chronic conditions, we’re able to help our members stay healthier and out of the hospital. And that leads to lower costs for members themselves,” said Chris Walker, associate vice president of Enterprise Transformation and Interoperability, Humana. “This partnership – and the positive results we’ve collectively achieved – is another example of how we are working together to improve patient care and deliver better health outcomes.”
athenahealth continues to expand its work with payer organizations, boosting information sharing across its network of more than 160,000 providers and facilitating new pathways to improve patient outcomes. To date, athenahealth has surfaced information on more than 25 million care and diagnosis gaps across commercial, Medicare, Medicaid, and ACA lines of business. The company has additional solutions that support provider and payer collaboration, including electronic prior authorization, transition of care, and referral management capabilities.
“We are working to create a thriving healthcare ecosystem that delivers accessible, high-quality, and sustainable care for all,” said Sam Lambson, vice president of Product Management, Data and Ecosystem Platform for athenahealth. “Our work with Humana and Your Health is an example of exactly what that ecosystem can look like when practices are equipped with purpose-built, innovative solutions that ease clinician burden and enhance patient outcomes. Facilitating collaboration between payer and provider organizations to improve care and eliminate administrative tasks is how we can deliver care experience that patients expect and deserve.”
The KLAS Points of Light annual awards celebrate success stories achieved by payers, healthcare organizations, and healthcare IT companies who have partnered to reduce costs and inefficiencies and improve patient experience. The organizations are honored by the recognition and recently presented about their collaboration at the KLAS K2 Collaborative Summit, May 20-22 in Salt Lake City, UT.
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Source – businesswire
