Availity® Co-Honored with 2025 KLAS Points of Light Awards for Care Gap Closure and Payer-to-Payer Data Exchange

Availity, the nation’s largest real-time health information network, has been twice named a 2025 Points of Light Award recipient by KLAS Research.

These recognitions celebrate two case studies with leading national health plans. One award recognizes Availity’s efforts to improve clinical data exchange and provider engagement through innovative digital tools within Availity’s multi-payer provider portal, designed to streamline quality and risk care gap reporting and closure.

Together, the organizations replaced time-consuming, paper-based processes with integrated, electronic solutions that notify providers of quality and risk documentation gaps and allow them to submit the required information quickly and securely within their existing workflows to document patient care gap closure and support value-based care initiatives.

The other award recognizes Availity’s work with three national payer organizations to enhance payer-to-payer data exchange by developing a centralized connectivity hub, to accelerate interoperability mandate compliance and facilitate more seamless, interoperable exchange of member health plan data as they transition across plans, ultimately resulting in reducing care gaps, administrative inefficiencies, and data fragmentation during member transitions between health plans.

This innovative solution enables multiple payer organizations to reduce the need for establishing multiple end-point connections with health plans, improves continuity of care, and supports compliance with upcoming CMS interoperability mandates.

“Availity is proud to be recognized by KLAS, which embodies our shared commitment to reducing administrative burden in healthcare, enhancing the provider experience, and advancing healthcare interoperability,” said Ashley Basile, Clinical Chief Product Officer, Availity. “Through our digital care gap tools, we are empowering providers with a unified, multi-payer digital workflow to improve quality reporting and care outcomes. At the same time, our payer-to-payer data exchange initiative is helping health plans support better continuity of care for members as they transition between plans and support CMS mandate compliance.”

Availity Digital Care Gap Tools

Key results from the digital care gap reporting collaboration include 34,000+ quality measures submitted electronically through Availity’s multi-payer portal as of October 2024 (an average of two care gaps closed per form submitted during the measurement period). In addition:

• 70% of network providers now have access to Availity’s digital care gap tools, up from just 25%
• In addition to improved HEDIS and Stars performance, considerable financial savings were generated through:
  • Reduction in need for manual retrieval of medical records to support submissions; estimated $15 - $25 saved per medical record no longer required
  • Reduction in estimated $10,000 in print, mail, and handling costs per quarterly mailing no longer required ($40,000 annually for each quarterly mailer)

Payer-to-Payer Data Exchange

Key results from the payer-to-payer collaboration include:

• Successful implementation of a centralized hub-and-spoke model for secure payer-to-payer data exchange
• Reduced onboarding time and administrative complexity for participating payer organizations
• Capture of long-term cost savings and improved data accuracy via a platform that delivers multi-payer connectivity efficiencies and economies of scale
• Strengthened compliance readiness for CMS interoperability mandates effective January 2027
• Enhanced continuity of care during member transitions between health plans through faster, standardized data sharing

The KLAS Points of Light annual awards celebrate success stories achieved by payers, healthcare organizations, and healthcare IT companies whose partnerships focus on reducing costs and inefficiencies while striving to improve the patient experience. The awards will be presented at the KLAS K2 Collaborative Summit, May 20–22 in Salt Lake City.

About Availity

Availity is the trusted partner for organizations seeking to realize the greatest value from clinical, administrative, and financial data. Positioned at the nexus of provider, health plan, and consumer health information, Availity develops scalable, innovative solutions for healthcare data acquisition, standardization, transparency, automation, and exchange among health plans, providers, and technology partners. As one of the nation’s largest health information networks, Availity facilitates billions of clinical, administrative, and financial transactions annually. Learn more at www.availity.com.

View source version on businesswire.com: https://www.businesswire.com/news/home/20250521803769/en/

"Availity is proud to be recognized by KLAS, which embodies our shared commitment to reducing administrative burden in healthcare, enhancing the provider experience, and advancing healthcare interoperability."