Castell saves $2.8M annually and closes nearly 2,800 care gaps overnight with AI-automated payer chart review

Castell, a population health services company created by Intermountain Health serving 900,000 patients, struggled with manual chart review for payer care gap attestation. Failing to close care gaps resulted in missed diagnoses, increased healthcare spending, and lower performance on value-based care contracts. Completing this work across all 468 providers without automation would have required an additional 47 full-time care coordinators.

Castell partnered with Notable in 2021 to deploy Intelligent Population Health automation, starting with payer care gap attestation for United Healthcare and expanding to Select Health in 2022. The platform automatically surfaces actionable data from the Cerner EHR, validates closed care gaps, and reports them to payers — covering five care gaps including Colon Cancer Screening, Breast Cancer Screening, and Diabetes-related metrics.

Notable reviewed over 100,305 patient charts and submitted 6,915 for payer care gap attestation, resulting in a 6.9% increase in average closure rate across five care gap types. The automation saved 8,360 hours of manual staff time in two weeks and generated $2.8M in annual cost savings equivalent to 47 FTE, while reducing chart review time by 70%.

• Automating payer care gap attestation at scale requires EHR integration that can surface actionable documentation prior to and after patient encounters in a single workflow.
• A digital workforce can replace the equivalent of dozens of FTEs for repetitive data review tasks, unlocking both cost savings and faster care gap closure.
• Starting with one payer and expanding incrementally (United Healthcare → Select Health) allows population health organizations to validate ROI before scaling.