Population Health Dashboard
Aggregate health metrics, risk distribution, and quality outcomes across your enrolled population
Total Population
8,432
↑ 2.3% MoM
Active enrolled members
High Risk
847
↑ 1.1% MoM
10.0% of population
Rising Risk
1,686
↓ 0.5% MoM
20.0% of population
HEDIS Composite
78%
↑ 3.2% YoY
vs. 75% national avg
Stars Rating
4.0 ★
↑ 0.5 YoY
CMS Overall Star Rating
Risk Tier Distribution
Current population segmentation by clinical risk level
Stable3,37340%
Low Risk2,53030%
Rising Risk1,68620%
High Risk84710%
Top Chronic Conditions by Prevalence
Percentage of enrolled members with each condition
Quality Measure Summary
Key HEDIS and Stars measures with performance vs. targets
| Measure Name | Current Rate | Prior Year | Plan Target | Gap Count | Status |
|---|---|---|---|---|---|
| Breast Cancer Screening (BCS) | 72% | 68% | 80% | 673 | Near Target |
| Colorectal Cancer Screening (COL) | 61% | 58% | 75% | 1,182 | Below Target |
| A1C Control (<8%) | 71% | 69% | 70% | 104 | At Target |
| Blood Pressure Control (<140/90) | 68% | 65% | 72% | 338 | Near Target |
| LDL Screening (CDC) | 82% | 79% | 80% | 0 | At Target |
| Medication Adherence — Diabetes | 74% | 71% | 80% | 521 | Near Target |
| Annual Wellness Visit | 54% | 49% | 65% | 929 | Below Target |
Care Gap Opportunities
High-impact gaps with estimated quality and financial impact
Annual Wellness Visits — Unscheduled
929
Est. $1.2M value
Colorectal Cancer Screening — Overdue
1,182
Est. +4.2% quality score
Medication Adherence — Diabetes (PDC <80%)
521
Est. $640K in avoidable costs
Breast Cancer Screening — Reminder Needed
673
Est. +2.8% quality score
A1C Testing — Overdue (HbA1c >12 months)
338
Est. $280K clinical risk reduction