Skip to content
Book a demo
An older man at his yearly diabetic eye exam with his optometrist

Care Gap Closure

Close more care gaps with the whole picture.

Fold joins EHR, claims, lab and HIE data into one list of open gaps. AI agents find the evidence and book rechecks. Your quality lead sets the rules.

Book a demo

How it works

From a missing result to evidence ready to send.

The same four steps as every Fold workflow. Here the signal is an open quality measure.

  1. 1Signals in
    Claims · Nov 3No A1c on file this year
    HIE · 3 wkA1c 7.9% from Quest
    EHR · AugType 2 diabetes, on metformin
    Labs · OcteGFR under 60 since July
  2. 2One patient context
    MEMargaret Ellison, 74Medicare Advantage · diabetes
    Last visit Oct 29Prefers morning callsDaughter Claire helpsLives alone
    Care gap open: A1c controlMeasure year closes Dec 31
  3. 3Next best action
    Attach the A1c result and book a recheck
    AI agent found the result in the HIE
    AI agent attached the source report
    AI agent drafted the supplemental data entry
    Ready for Dr. Hayes · Nov 4
    RHDr. R. HayesOwner · makes the call
  4. 4Owner signs off, result tracked
    Dr. Hayes signed
    Evidence approved
    Ready for your team to submit
    Recheck booked in 3 months
    Evidence and sign-off kept with the gap

Your EHR sees the visit. The plan sees the claim. Fold sees both.

Care already done often stays open on the plan’s list. Fold finds the proof in EHRs, HIEs, labs and faxes. Maria Santos checks it, and your team sends it to the plan.

Maria Santos checks each closure and Emily Carter approves it. Every closure keeps its source and the measure rule. Real gaps, with no care on file, go to outreach.

Three AI agents work the gaps. A quality lead sets the rules.

One finds evidence in HIE and fax records, one texts members due a recheck, one books it. Emily Carter approves each closure. Meet the AI agents

Emily Carter, quality lead, reviewing open measures with a colleague

Three AI agents, one approver

See where each measure stands, and who needs a recheck.

Each measure shows where you stand against target. Drill to a practice, then a patient, and each recheck goes out with an owner and a due date.

3xmore care gaps closed with evidence attached. Every closure carries the record that proves it.Source: Fold platform data, all customers, 2025 vs 2026.

How to drill from a measure to an owned action

  1. Measure
  2. Practice
  3. Member list
  4. Member
  5. Action
  6. Owner
A care management team meets beside a wall screen

Customer story · A care management organization

Every case in one place, with an owner.

What changed
Every case has one record, an owner and a clear status.
Who checks
Case owners and clinicians make every care decision.
Read the story

Show the evidence behind every closure and exclusion.

Can Fold exclude a member from a measure without review?

No. The AI agent attaches the source for each exclusion, such as hospice care, and your quality lead approves it.

Does supplemental data hold up in audit?

Fold keeps the source document and its review history to support audits, including primary source verification where required.

How does Fold help with ECDS reporting?

Fold stores each result as structured data with its source and approver. ECDS reporting still depends on each measure’s data sources.

Case study

See it in a case study.

Provider networks

How a California MSO moved its care team onto one worklist

A care team spread across four tools, and the work that kept slipping between them.Get the case study

Size your gap work
before sharing any PHI.

Send gap counts by measure, and we map evidence, approvals and next actions with your quality team.

Book a demo