AI Population Health Reporting Agent
Automating Population Health Reporting with AI
Unified Data Acquisition and Normalization
The agent ingests claims, EHR, HIE, registry, and pharmacy data, then maps to standard terminologies (SNOMED CT, LOINC, RxNorm) and VSAC value sets—eliminating manual reconciliation across disparate sources.
Automated Measure Calculation and Gap Closure
CQL logic evaluates each measure's populations, exclusions, and stratifications in real time, surfacing care gaps and chase lists so teams can prioritize outreach before submission windows close.
Submission-Ready Validation and Audit Support
Automated conformance checks validate QRDA III structure, identifiers, and cardinality before submission, while generating audit artifacts and documentation to satisfy NCQA and CMS requirements.
How Cassidy automates this using AI
Step 1: Trigger on reporting cycle or data event
The Workflow activates on a scheduled cadence (monthly, quarterly, or at submission window open) or when new clinical data arrives—ensuring measure calculations always reflect the latest information.
Step 2: Ingest and normalize multi-source data
Cassidy pulls claims, EHR extracts, HIE feeds, immunization registries, and pharmacy records into the Knowledge Base, mapping each element to VSAC value sets and program-specific data models (HEDIS ECDS categories, QDM for eCQMs, eICR for eCR).
Step 3: Build cohorts and apply measure logic
The agent identifies eligible populations per program—applying enrollment logic for HEDIS product lines, MIPS participation pathways (individual, group, APM Entity, APP/APP Plus), and eCR reportability rules—then executes CQL to compute numerators, denominators, exclusions, and stratifications.
Step 4: Generate care gap lists and outreach
Cassidy surfaces patients missing numerator criteria, creates prioritized chase lists, and drafts outreach communications or documentation prompts to help clinical teams close gaps before deadlines.
Step 5: Validate and prepare submission files
The Workflow runs conformance checks on QRDA III structure, identifiers (TIN, NPI, APM Entity IDs), nullFlavor rules, and CEHRT requirements—flagging errors for Human-in-the-Loop review before finalizing submission packages.
Step 6: Submit and monitor results
Cassidy submits validated files via QPP API, IDSS, or AIMS transport (for eCR), then tracks acceptance receipts, error reports, and Reportability Responses—alerting teams to rejections and managing succession rules for replacement submissions.
Step 7: Surface performance feedback and audit artifacts
The agent delivers dashboards with measure trends, stratification performance, and scoring feedback, while compiling audit documentation (Audit Roadmaps, supplemental data validations, conformance reports) for NCQA auditors or CMS review.
Implement it inside your company
- Hands-on onboarding and support
- Self-paced training for your team
- Dedicated implementation experts
- Ongoing use case discovery
- ROI tracking & analytics dashboards
- Proven playbooks to get started fast
