Business solutions
Practice analytics and risk stratification that help you run leaner and get paid accurately.
Risk stratification
We help organizations predict expected cost of care so they can compete on price and quality rather than on how healthy their members happen to be. Accurate risk adjustment means plans are paid fairly for both high- and low-cost patients.
Risk scores shape Medicare Advantage payment in three ways: they adjust the county benchmark a plan bids against, they set the rebate a plan can turn into extra benefits, and they adjust payment for each enrolled member.
What we recommend
- Keep the risk adjustment model predictable and stable
- Hold coding-intensity adjustments at the statutory minimum
- Improve accuracy for patients with several chronic conditions
- Account for social determinants of health
- Validate encounter data before relying on it
- Phase in encounter data at a measured pace
- Weigh encounter data against coding-intensity adjustment
- Keep model changes transparent
Ready to tune your practice?
Tell us about your organization and we will show you where analytics can help.
Start a remote care program this quarter
Bring us your patient census. We will show you who qualifies, what it takes to launch, and what your first month looks like.
