Cavo Health Launches New AI Solution For Hybrid HEDIS Abstraction, Setting a New Standard in Accuracy And Transparency

Precise Word Matching AI outperforms machine learning AI to help payers close care gaps, improve Star Ratings, and advance patient outcomes

INDIANAPOLIS, IN, UNITED STATES, September 9, 2025 /EINPresswire.com/ -- Cavo Health, the U.S.- based healthcare technology company, today announced the launch of its hybrid HEDIS abstraction solution powered by Precise Word Matching AI. Unlike machine learning models that rely on statistical predictions, this rules-based AI engine precisely delivers unmatched accuracy, abstraction speed, and audit-ready transparency—ensuring payers meet quality standards with confidence.

HEDIS (Healthcare Effectiveness Data and Information Set) measures are nationally recognized benchmarks that influence health plan quality ratings, Medicare Advantage Star Ratings, CMS bonus payments, and patient outcomes. Yet abstraction of hybrid HEDIS measures is complex: overlooking a single lab value, date, or phrase can mean the difference between closing a care gap and missing a quality opportunity.

Cavo Health’s deterministic AI eliminates that risk. By aligning with NCQA specifications, Precise Word Matching AI captures every valid data point the first time - including clinical synonyms, abbreviations, and unit variations - while machine learning often misses subtle but critical evidence.

“HEDIS performance is both a quality imperative and a financial driver for health plans,” said George Witwer, CEO of Cavo Health. “Our Precise Word Matching AI removes the guesswork. It guarantees compliant hybrid HEDIS abstraction with speed and accuracy - empowering payers to strengthen Star Ratings, reduce audit risk, and deliver better care to their members.”

Cavo Health Advantages for Payers

•Dual-purpose chart review: Conduct risk adjustment coding and hybrid HEDIS abstraction from a single chart with ease – toggle between risk adjustment and HEDIS projects with one click.

•Cost savings: Reduce spending through bundled pricing and lower review costs with faster abstraction and streamlined efficient workflows.

•Complete visibility: Capture patient refusals and reasons for open gaps, generating provider chase lists that drive education and engagement.

•Higher quality scores: Improve Star Ratings, earn CMS bonus payments, and optimize reimbursement.

•Audit-ready accuracy: Ensure compliance and lower penalty risk.

Benefits for Patients

• Improved preventive care: Ensure timely screenings, labs, and interventions.

• Better care coordination: Close gaps and manage chronic conditions proactively.

• Transparency in quality: Reflect improved care through publicly reported HEDIS scores.

Cavo’s Coder for hybrid HEDIS abstraction highlights relevant documentation, captures measure completions and exemptions, and tracks values such as blood pressure and A1c for earlier intervention. By unifying quality and risk adjustment accuracy in a single platform, Cavo Health helps providers close more care gaps, improve outcomes, and deliver proactive, patient-centered care – all while raising financial performance.

About Cavo Health

Cavo Health empowers healthcare payers and providers with the most accurate, specific, and complete automated diagnostic coding, hybrid HEDIS abstraction, and clinical documentation (CDI) solutions. Its proprietary Precise Word Matching AI powers a next-generation platform designed to support Medicare Advantage, Medicaid, Commercial Risk Adjustment, and Quality programs. The HITRUST-certified platform is audit-ready and purpose-built to maximize coding accuracy, reduce RADV exposure, improve Star Ratings, and deliver stronger financial and patient outcomes.

Keli Wilson
Cavo Health
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