Transform your **Quality strategy** with clinical AI

A scalable solution for automated gap closure that leverages clinical evidence already in your system.

Scope a no-cost proof of concept
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Scope a no-cost proof of concept

Validated impact: Capture in action

Real results driven by clinical intelligence.

15%

improvement in Stars HEDIS performance on avg. per measure

up to 10k

gaps closed for every 100,000 lives trapped in unstructured data

20-25%

closure rates for high-value measures

5:1

return from compliance-ready automation

How Cohere Capture™ works

Extract clinical value from unstructured data

Designed to help health plans shift away from manual abstraction, Cohere Capture deploys clinical AI agents that identify, evaluate, and submit gap closure evidence, reasoning across records at population scale.

  • Target the right evidence

    Identify clinical records with the highest probability of containing gap closure evidence, removing the waste to drive efficient, automated gap closure.

  • Unlock existing clinical data

    Leverage your existing clinical records, imaging reports, and EHR narratives to find evidence for gap closures and exclusions without additional provider outreach.

  • Output validated results

    Process large volumes of unstructured (and structured) documentation and automatically deliver compliance-ready results directly to your HEDIS engines.

Explore the Cohere Unify Platform

What makes Cohere Unify different?

Connect clinical intelligence across healthcare operations

Explore the Cohere Unify™ platform to learn more about the agents powering workflows across a health plan enterprise.

Explore the Cohere Unify Platform

Overview

Scalable capabilities for health plan quality teams

Our clinical AI models process tens of millions of records, automatically combing through structured and unstructured data to support year-round measurement.

Benefit

Capabilities

Source-agnostic data extraction

Find gap-closing evidence across utilization management data, imaging, lab results, and care management notes.

Clinically trained AI models

Achieve over 98% accuracy with domain-specific AI models built and refined by clinical experts.

Existing UM data advantage

Current UM customers can turn existing data directly into closed quality gaps–with the ability to add more data sources for additional gap closure.

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Already a customer running UM on Cohere Unify?

Clinical evidence for HEDIS and Star gap closure is already flowing through your existing prior authorization workflows in Cohere Unify, giving your team a practical way to uncover additional value. Speak to our team to learn how you can put your plan’s UM data (and other clinical data sets) to drive measurable quality improvement.

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Benefits

Key advantages of Cohere Capture

Unlocking unstructured data supports enterprise quality strategies and reduces administrative friction.

Protect and improve Star ratings

Improve HEDIS measure performance to secure rebates and quality bonus payments. Moving from a 3- to a 4-Star rating can generate about $57 million in revenue per 100,000 lives.

Reduce or eliminate manual chart abstraction

Avoid the high costs of retrospective manual reviews by identifying both gap closures and denominator exclusions automatically.

Pay for performance

Align costs with outcomes through a pricing model based on closed gaps rather than the volume of charts reviewed.

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Forward design

Prepare for full-population measurement and ECDS

As NCQA retires hybrid measures in favor of year-round, full-population measurement, legacy manual chart abstraction is no longer viable. Health plans must transition to digital quality measures. Cohere Capture delivers the scalable clinical data extraction needed to meet Electronic Clinical Data Systems (ECDS) reporting mandates without placing additional administrative burden on providers or stretched quality teams.

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Part of a connected
clinical intelligence platform

Cohere Capture is not a standalone quality tool. It is built on the same clinical context layer and precision AI foundation that powers Cohere Unify across utilization management, appeals, care management, and claims.

Integrated clinical data

Connected workflows

Compounding intelligence

Beyond manual abstraction: solving hidden quality challenges

  • Scale data extraction securely

    Drive high volumes of automated gap closure directly into HEDIS engines, with over 98% accuracy across clinical data sets processed.

  • Automate closures directly to HEDIS engine

    Fully automated, compliance-ready submissions directly to your HEDIS engine–no additional manual work required.

  • Align with year-round measurement

    Shift from a chaotic end-of-year hybrid push to a continuous, proactive workflow that monitors full-population quality gaps year-round.

  • Improve throughput with assistive AI

    When gap closures cannot be fully automated, feed AI-prepared opportunities to nurse reviewers–surfacing potential closures, removing the noise, and dramatically expanding gap closure throughput.

  • Reduce provider abrasion

    Reduce additional, abrasive medical record requests by extracting value from records already submitted during regular care workflows.

**Modernize** your quality gap closure operations

Learn how Cohere Capture leverages the gap-closing evidence already residing within your systems through a no-cost proof of concept trial.

Get Started Now
Get Started Now

Smarter quality improvement starts with the right questions

Explore common questions about our quality intelligence solution.

How does Cohere Capture differ from traditional chart retrieval and abstraction vendors?

Traditional vendors charge based on the volume of charts reviewed, regardless of whether a gap is closed. Based on industry averages, a fee of $20 per chart can easily translate to a cost of $200-$400 per gap closed. Cohere Capture uses an evidence targeting model to process records with the highest probability of containing evidence, and our pay-for-performance pricing means you pay primarily for closed gaps.

Do current Cohere utilization management customers need additional data integration to get started with Cohere Capture?

No. Current Cohere utilization management customers can get started with the prior authorization and clinical data already flowing through Cohere Unify. That existing data is often enough to begin identifying HEDIS and Stars value quickly. Cohere Capture can also integrate additional data sources, and plans can strengthen performance by adding more clinical feeds to expand evidence capture and close more gaps.

Will this help our plan prepare for NCQA digital quality measure mandates?

Yes. While Cohere Health can certainly help plans struggling with hybrid season crunches, the platform is purpose-built for the transition to ECDS and digital quality measures–enabling health plans to shift from sample-based hybrid reporting to year-round, full-population measurement.

What types of unstructured data can the clinical intelligence engine process?

The solution is source-agnostic and accurately extracts gap closures and denominator exclusions from utilization management notes, diagnostic imaging reports, EHR narratives, specialist notes, and other unstructured clinical documents.

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