Risk Adjustment
Products that provide methods and techniques for identifying high-risk members/patients along with improving gaps in HCC coding and CMS reimbursement.
Subject Expert
Paul Hess
Research Director
Best in KLAS Category
Report Abstract
Key Findings:
- Functionality the Number-One Reason for Selection; Cost a Common Reason for Both Selection & Replacement
- Episource’s Purchase Energy Has Grown Consistently; Change Healthcare Customers Leave after Security Breach
- Inovalon* & Veradigm Considered but Chosen Less Frequently; Several Inovalon Customers Leave, Citing Unmet Expectations; Veradigm Stands Out for Submissions
- Apixio Selected by Multiple Organizations & Current Customers Report Improved Loyalty; Organizations That Replace Edifecs Often Cite Declining Product & Relationship Post-Acquisition
- Datavant Chosen for Chart-Retrieval Expertise; Current Customers Note Easy Chart-Retrieval Process
- EXL’s Analytics Facilitate Decision-Making for Customers; Arcadia Provides Retrospective & Prospective Analytics, Receives Mixed Feedback on Integration
- Vatica Health’s Prospective Solution Identifies Gaps at Point of Care
- Matrix Medical Network* & Signify Health*—Vendors Focused on In-Home Health Assessments—Close Quality Care & Risk Gaps despite Shortcomings
*Limited data
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Featured IT Vendors/Products
Performance Data
Overall Score by Product
Products Appearing in Decisions
Overall Score by Question Topic
Provider Facility Size by Product
Provider Facility Type by Product
Reducing Filters
Unlike sizing filters, reducing filters DO NOT recalculate scores based on the evaluations that meet these requirements. They narrow the list of solutions to show the vendors and solutions that can meet a specific need.
This data is based on interviews with a sample of the firms' recent clients. As a result, it is not necessarily comprehensive of all work a firm may do in this segment.
We require a minimum of 2 confirmations of a service performed in the last 3 years for a solution to qualify.