BOSTON– In a move hailed as a model for effective healthcare collaboration, athenahealth, Humana, and Your Health have been awarded the 2025 KLAS Points of Light Award for their efforts to close care gaps and ease the administrative load on clinicians through improved data sharing.
The award-winning case study, “Closing Care Gaps & Reducing the Administrative Burden Through Improved Data Sharing,” showcases how integrating payer data into clinical workflows can improve outcomes for patients—particularly among those on Medicare Advantage plans. The collaboration between athenahealth, a healthcare technology leader, Humana, a national health insurer, and Your Health, a primary care practice based in South Carolina, has yielded measurable results in early intervention and diagnosis.
Using athenahealth’s cloud-based platform and athenaPayer’s Care and Diagnosis Gaps tools, Your Health clinicians are now able to access real-time, patient-specific insights directly within their existing workflow. This integration allows clinicians to identify and address health issues before or during appointments, rather than relying on fragmented or delayed data.
The initiative uncovered an average of 4.8 additional care gaps and 4.7 additional diagnosis gaps per Humana Medicare Advantage member. So far, Humana has been able to close 35% of its Centers for Medicare & Medicaid Services (CMS) Star quality measure gaps through this effort.
Will Stillinger, COO of Your Health, emphasized the clinical impact of the partnership. “This approach empowers our team to deliver preventative, personalized care while significantly reducing administrative burdens,” he said. “We’re able to intervene earlier, reduce costly complications, and explore future care pathways that include social determinants of health.”
Validated data captured in the electronic health record is automatically shared with Humana using Da Vinci interoperability standards, ensuring accurate reporting and quality tracking. Clinicians spend less time identifying care gaps and more time focused on patient care, enhancing both the efficiency and effectiveness of each visit.
Chris Walker, associate vice president of Enterprise Transformation and Interoperability at Humana, noted the broader value of the collaboration. “By prioritizing preventive care and chronic disease management, we’re keeping members healthier and reducing costs,” he said. “This partnership shows what’s possible when payers and providers work together with aligned goals.”
athenahealth, which supports a network of over 160,000 providers, continues to scale its payer collaboration efforts. To date, the company has helped surface over 25 million care and diagnosis gaps across various insurance lines, including commercial, Medicare, Medicaid, and ACA markets. Additional tools supporting transitions of care, referrals, and electronic prior authorizations are also in place to enhance provider-payer cooperation.
“This collaboration reflects our commitment to building a thriving, sustainable healthcare ecosystem,” said Sam Lambson, athenahealth’s vice president of Product Management, Data and Ecosystem Platform. “By reducing clinician burden and enabling smarter care delivery, we’re helping practices deliver the kind of care patients expect and deserve.”
The recognition by KLAS highlights how streamlined data sharing can drive improvements in clinical outcomes, patient satisfaction, and operational efficiency—all while alleviating pressure on an overburdened healthcare workforce.
