1 Introduction

Send payer-generated coding and care gaps using Quality Management for Payers.

Quality Management for Payers enables payers to submit payer-computed coding and care gaps to Oracle Health. By using existing electronic health record (EHR) integrations, these assets surface payer gap datasets directly in the provider’s workflow at the point of care. This capability allows gap information to be integrated directly into clinical workflows, facilitating timely intervention and supporting proactive care, accurate Risk Adjustment Factor (RAF) scores, quality measure attainment, and reduced administrative burden associated with manual chart requests.