FabrixMed for Health Plans

Close care gaps. Improve access. Reduce avoidable cost.

Deploy specialty-enabled virtual care and diagnostic workflows that bring care closer to the member, close high-value gaps, and create measurable ROI across quality, cost, and network performance.

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FabrixMed workflow

The challenge

Health plans carry the financial risk when members do not receive timely, appropriate care. Care gaps persist because the healthcare system is fragmented — the result is worse outcomes, higher claims cost, weaker quality performance, and avoidable leakage of plan dollars.

Members miss preventive screenings and primary care lacks fast specialist access
Specialty appointments are delayed or unavailable with diagnostic data captured too late
High-risk members fall through the cracks with avoidable emergency visits
Documentation gaps weaken quality reporting and network access issues create dissatisfaction
Plan dollars leak into high-cost, poorly coordinated care settings

What FabrixMed enables

Care gap closure programs

Deploy workflows that identify members who need screening, diagnostic review, or specialty follow-up.

  • Diabetic retinal exams
  • Cardiovascular risk triage
  • Hypertension-related follow-up
  • Behavioral health access
  • Chronic disease monitoring
  • Post-discharge specialty follow-up

Remote specialist access

Connect members or local care teams with remote specialists for synchronous or asynchronous consultation.

  • Transportation and geographic barrier reduction
  • Network capacity expansion
  • Dermatology review
  • Specialty follow-up coordination

Diagnostic capture and interpretation

Capture clinical data locally and route to qualified specialists for remote review and actionable guidance.

  • Retinal imaging
  • ECG review
  • Wound imaging
  • Slit lamp imaging
  • Specialty-specific diagnostic data

Risk-based member triage

Structured triage workflows that direct members to the right level of care based on clinical need.

  • Rapid review pathways
  • Monitoring workflows
  • Urgent escalation routing
  • Population risk stratification

Documentation and workflow support

Clean workflows that support reporting, follow-up, defensibility, and quality-program alignment.

  • Referral routing
  • Clinical documentation
  • Follow-up tasks
  • Member outreach coordination
  • Quality-program support
FabrixMed does not replace the health plan, provider network, physician judgment, or emergency escalation pathway. The health plan defines population, program goals, clinical scope, and network strategy. FabrixMed helps operationalize the care pathway.

Strategic benefits

  • Close high-value care gaps tied to chronic disease, preventive care, and risk management
  • Improve quality and performance metrics with better access, documentation, and follow-up
  • Reduce avoidable utilization through earlier specialty input and diagnostic review
  • Expand network capacity without brick-and-mortar expansion or local specialist dependency
  • Reduce leakage by routing members into plan-aligned care pathways

Value measures you can impact

HEDIS and Star measure performance Care gap closure rate Avoidable ED and specialty utilization Member satisfaction and access scores Claims cost on preventable gaps Diagnostic follow-through rate Network leakage rate Risk adjustment documentation completeness

Operational & financial ROI

Close high-value care gaps

Target members overdue for screenings, diagnostic review, or specialty follow-up — especially for quality measures tied to chronic disease and preventive care.

Improve quality and performance metrics

Better access, documentation, and follow-up support stronger quality performance across plan priorities.

Reduce avoidable utilization

Earlier specialty input and diagnostic review help prevent unnecessary emergency department visits, delayed complications, and avoidable downstream cost.

Expand network capacity

Increase access to specialty expertise without relying only on brick-and-mortar expansion or local specialist availability.

Improve member experience

Members benefit when care is easier to access, closer to home, and better coordinated.

Support risk adjustment and clinical documentation

Structured clinical workflows help ensure relevant findings, recommendations, and follow-up actions are captured in a more organized way.

Reduce leakage and fragmentation

Route members into plan-aligned care pathways instead of letting them drift into high-cost, poorly coordinated settings.

Turn access into ROI

Deploy targeted care programs that improve member outcomes and protect plan dollars without building every part of the care delivery stack.

Example workflow

1

A health plan identifies a target member population or care gap.

2

Members are routed into a FabrixMed-enabled workflow.

3

Clinical data is captured through a local provider, partner site, or diagnostic device.

4

The case is routed to the appropriate specialist or interpretation partner.

5

Findings and recommendations are returned to the care team.

6

The member receives follow-up, escalation, or monitoring based on clinical need.

7

The plan receives a more structured pathway for quality improvement, cost control, and care coordination.

Turn access into ROI

Talk to FabrixMed about health plan solutions — close gaps, improve quality performance, reduce avoidable cost, and expand access to specialty care.

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