RISK ADJUSTMENT

Accurate risk scores & payments

QUALITY

Improve quality & boost ratings

POPULATION HEALTH

Optimize outcomes & reduce utilization

Risk Adjustment

No SAS® required CMS-HCC models
Integrate CMS-HCC models into ETL
Ensure complete & accurate payments
AI-powered HCC code identification
Identify opportunities for improvement with and without medical record review

Identify and manage prospective gaps in care
Prioritize outreach with proven AI and machine learning adherence models
Medicare Advantage Star Ratings, ACA Quality Ratings System, and other quality measurement systems
Improve patient experience measure performance (CAHPS / HOS)

Quality

Population Health

Identify and stratify by member cohort and risk
Predict future outcomes, utilization, and costs
Engage members for care coordination and intervention
Analyze physician practice to improve quality and reduce costs
Monitor and evaluate programs to determine success, learn, and improve

Health Plan Offerings

Improve your health plan risk, quality, and population health performance