Risk Adjustment Analytics & Reporting:
Through the use of
Through the use of
Big Data Mining
Big Data Mining
Multiple Predictive Models
Multiple Predictive Models
Confidence-adjusted risk adjustment algorithms
Confidence-adjusted risk adjustment algorithms
Accurately measure Risk Adjustment opportunity:
Accurately measure Risk Adjustment opportunity:
Dynamically deploy your intervention initiatives in order to
Optimize risk-adjusted revenue
Avoid administrative waste
Dynamically deploy your intervention initiatives and:
Dynamically deploy your intervention initiatives and:
Projects MA Mid-Year and Final-Year Revenue Adjustment amounts by Contract and PBP
Monetizes ACA Gap Closures as contribution to year-end risk transfer payments
Performs Annual True-Up on Retrospective Rate Adjustments by state for each Medicaid population (TANF, SSI, ABD, and Duals)
Track Year-to-Date cost and utilization against Alternative Payment Models (APMs) to allow provider organizations to actively manage success with value-based contracts
Delivers real-time Gap Closure Rates, Risk Factor, and Risk Revenue Projections