Analytics experts at your service
Understanding siloed analytics is challenging for payers and providers. Fragmented risk adjustment programs and limited in-house capabilities can hinder strategic, coordinated action and may impact overall performance.
That’s why we’ve created a solution that combines technology and strategic experts to identify areas for improvement in risk adjustment programs and deliver strategic recommendations to enhance impact.
Think of us as an extension of your team
RAF reporting
Our analytics team will create a comprehensive report on year-over-year risk adjustment factor (RAF) trends, as well as how your organization’s RAF score performs against benchmarks.
Actionable task lists
We identify high-risk members who need immediate care, as well as unengaged patients that require outreach. We also provide you with a list of providers with a higher or lower than average patient engagement rate and those with a higher or lower than average percentage of high-risk members.
End-to-end execution
We offer a comprehensive, end-to-end product portfolio designed to execute member and provider programs at scale — enabling seamless implementation of strategic recommendations across coding, retrieval, submission and other operational areas.
HCC analysis
We provide insights into how your HCC recapture rates are trending over time, as well as factors that are impacting these rates. We also identify the historical and current percentages of members in your program with no HCCs.
Full consulting support
Our experts act as an extension of your team. With Risk Adjustment Program Assessment, you’ll be partnered with a dedicated project team, as well as a group of data strategists, product directors and analysts.
Key benefits
Data-driven interventions
Our multilayered analysis helps provide deep insights into how individual interventions impact program success.
Reduce administrative burden
Our assessment may help reduce the resources required to manage and analyze data.
Seamlessly executed interventions
Beyond just delivering analysis, we have the ability to carry out many of the recommendations we make, from coding to retrieval and more.
Close member gaps
We leverage advanced suspecting methodologies to identify member-level gaps and clinical indicators, supporting timely and targeted intervention.
Here’s how it works
Aggregate: Share your CMS and claims files with our team for a baseline analysis of member population.
Analyze: Our team aggregates and analyzes member data to provide a 360-degree view of your program performance.
Strategize: We meet with you one-on-one to present the Program Assessment, a roadmap of strategic interventions tailored to your needs.
Execute and monitor: You can then execute the recommended interventions through your existing vendor or through Optum.
Industry insights
Article
We provide actionable insights for health plans and providers to adopt a data-driven approach and achieve value-based care goals.
White paper
Unlock new efficiencies with a digital-first, AI-powered approach to empower value-based care and enhance health plan performance.
E-book
Creating a connected system to improve risk and quality outcomes.
Product information and resources
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Sell sheet
Overview of the Risk Adjustment Program Assessment
Learn how we can help your organization transform analytics into actionable outcomes.
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