Pilot Observations · MY2026 Prospective Season

What We've Observed in Early Deployments

Initial pilots focused on workflow execution — not marketing outcomes.

Ranges below reflect operational changes observed across early deployments. Results vary by plan, provider engagement, and data availability.

Section 00 · Execution Proof

Proof Must Show Execution — Not Just Activity

Podero does not just report activity. We report whether the operational work is producing usable, defensible evidence.

Retrieval Proof

  • Retrieval completion rate
  • Average turnaround time
  • Provider response rate
  • Past-due retrieval volume
  • Escalation volume
  • Centralized location resolution rate

Abstraction Proof

  • Charts reviewed
  • Evidence accepted
  • AI match acceptance rate
  • Overread agreement rate
  • QA correction rate
  • Negative reason distribution

Audit Readiness Proof

  • Evidence validation pass rate
  • Missing source flags
  • Missing identifier flags
  • Traceability issue rate
  • Audit-risk reduction
  • Submission-ready evidence count

Section 01 · Operational Improvements

Where Pilots Move the Needle

Observed across early MY2025/MY2026 deployments — measured against the plan's prior baseline workflow.

Area
Observed Change
Context
Retrieval backlog
↓ 20–40%
after measure-relevance prioritization replaced volume-driven chase
Time to first chart
1–3 days faster
fewer outreach loops; digital sources prioritized when available
QA issue detection
earlier stage
overread surfaces gaps before submission pressure builds
Abstraction rework
reduced
evidence captured against measure logic, not codes alone

Based on pilot observations. Results vary by plan, provider engagement, and data availability. Ranges are illustrative — not guaranteed outcomes.

Most breakdowns occur when retrieval completes — but abstraction lacks measure-valid evidence.

This is where compliance is lost — not at the reporting layer.

Impact Areas

Where Plans See Impact

Podero improves execution — not measure scoring. Compliance is determined inside your reporting engine; we make sure what arrives there is defensible.

  • 01Faster chart retrieval turnaround
  • 02Reduced duplicate provider requests
  • 03Fewer abstraction reworks
  • 04Earlier QA issue identification
  • 05Less last-minute audit preparation

Measurement

What We Track — Not What We Claim

Operational metrics plans can independently validate inside their own reporting environment.

01 · Retrieval Performance

  • Time to first chart received
  • Digital vs. manual retrieval rate
  • Provider-chase loop count per chart

02 · Abstraction Quality

  • % charts requiring rework
  • Evidence completeness vs. measure logic
  • Consistency across reviewers (overread)

03 · Audit Readiness

  • % charts audit-ready at submission
  • Missing documentation rate
  • PSV/MRRV support coverage

Illustrative Use Cases

Pilot Scenarios from Early Deployments

Regional Medicaid Plan

Challenge

Heavy reliance on manual provider outreach — limited visibility into request status, frequent duplicate chases.

What Changed

  • —Digitally-led retrieval introduced where data sources allowed
  • —Centralized request tracking across measures
  • —Structured abstraction tied to measure-level evidence

Observed Impact

  • ✓Fewer provider follow-ups required
  • ✓Faster initial chart receipt
  • ✓Visibility across retrieval and review in one queue
Medicare Advantage Plan

Challenge

Inconsistent abstraction outputs and last-minute audit prep — gaps surfacing during PSV/MRRV.

What Changed

  • —Standardized abstraction workflow with QA overread
  • —Real-time chart status tracking
  • —Pre-submission validation checkpoints

Observed Impact

  • ✓More consistent abstraction across reviewers
  • ✓Reduced last-minute audit preparation
  • ✓Tighter coordination between retrieval and review teams

Scope Clarity

What Podero Does — and Does Not Do

Clarity here builds more trust than any performance claim.

What we do

  • ✓Improve retrieval and abstraction execution workflows
  • ✓Accelerate chart acquisition through digitally-led strategies
  • ✓Structure clinical evidence for downstream submission
  • ✓Support audit readiness with consistent, traceable outputs

What we do not do

  • —Guarantee HEDIS® performance improvement
  • —Replace a plan's compliance or reporting engine
  • —Control provider responsiveness
  • —Override NCQA audit requirements

These are early operational observations — not guaranteed outcomes.

The purpose of the pilot is to validate this within your own workflow.

MY2026 pilots now onboarding · Limited capacity

Run a Pilot Before It Becomes Rework.

If your current workflow produces charts and codes — but still requires rework:

It's not an efficiency problem. It's an evidence problem.

Podero supports HEDIS®-related workflows but does not determine measure compliance. HEDIS® is a registered trademark of NCQA.