Medicare Advantage Quality: How Three Health Plans Are Closing Care Gaps

Identifying a care gap is only the beginning. For health plans, the real challenge is understanding why the gap remains open, choosing the right intervention, and ensuring members complete care and document it. In this episode of Bright Spots in Healthcare, leaders from Blue Cross Blue Shield of Michigan, Blue Cross Blue Shield of Minnesota, Fallon Health, and Arbiter AI explore practical strategies for closing the last mile in Medicare quality.

Hear how health plans use AI to uncover care already completed, extend outreach to members who might otherwise go unreached, improve collaboration with provider organizations, and target interventions based on the actual barriers members face. The discussion also explores how to scale proven approaches, make quality a shared organizational responsibility, and use data more effectively to improve care delivery and performance.

Download the Episode Resources Episode Guide Key takeaways and practical lessons from the conversation: www.brightspotsinhealthcare.com/wp-content/uploads/2026/10/Episode-Guide-Bright-Spots-in-Healthcare-10.22.26-1.pdf Key Insights Summary Guest takeaways and discussion highlights: https://www.brightspotsinhealthcare.com/wp-content/uploads/2026/10/Key-Insights-Summary-Arbiter.pdf

Request Arbiter's report: "Why Identified Care Gaps Stay Open, and What Closes Them, Contact Sherry Keyles at skeyles@brightspotsventures.com.

Featured Medicare Advantage Leaders

• Erica Krieger, Vice President, Quality, Blue Cross Blue Shield of Michigan

• John Willis, Program Manager, STARS, Blue Cross Blue Shield of Minnesota

• Angela Spanos, Vice President, Quality and Population Health, Fallon Health

• Jay LaBine, MD, Chief Medical Officer, Arbiter

What You'll Learn

Closing care gaps requires more than identifying members who need care. In this conversation, healthcare leaders share practical lessons and real-world examples you can apply to your own quality strategy.

• Find gaps that may already be closed by using existing clinical data more effectively

• Reach more members without overextending care teams through targeted outreach and escalation

• Give providers clearer, more actionable quality data to focus resources where they matter most

• Use AI where it fits best for defined populations, repeatable workflows, and scale challenges

• Measure completed care, not just activity and decide which interventions deserve to scale

Featured Resource: Why Identified Care Gaps Stay Open, and What Closes Them

Arbiter's report, "Why Identified Care Gaps Stay Open, and What Closes Them," shows where care gaps break down and how the right response changes depending on where the member is stuck.

It also includes strong questions health plans should ask their outreach partners about what they're measuring and whether they're achieving documented closure.

The report examines:

• Challenges in Care Gap Closure

• Where Gaps Leak

• Specific Breakdown Points and Proposed Fixes

• Three-Step Operating Model for Scale

• Case Study Results

• Key Partner Evaluation Questions

To request a copy, contact Sherry Keyles at skeyles@brightspotsventures.com.

About Arbiter

Arbiter is an agentic care orchestration platform that closes the last mile at population scale. It activates each member through personalized, multimodal outreach — AI video, SMS, voice, and portal — then returns the verified clinical record that proves the care happened, with licensed nurses in the loop.

Learn more: arbiter.ai.

Connect With Arbiter

To explore how Arbiter can help your team convert identified gaps into auditable closures, with the clinical record returned. Contact Sherry Keyles at skeyles@brightspotsventures.com to schedule a conversation with a senior Arbiter leader.

Panelist Bios

https://www.brightspotsinhealthcare.com/events/closing-the-last-mile-of-medicare-quality-from-care-gaps-to-smarter-action/#url

About Bright Spots in Healthcare

Bright Spots in Healthcare brings together health plan, health system and healthcare innovation leaders to share practical examples of what is working — and how others can apply and scale those ideas.

Bright Spots Ventures creates healthcare content, executive communities, private peer discussions and go-to-market programs designed to accelerate meaningful change.

Learn more: https://www.brightspotsinhealthcare.com/

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