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
Bradley Hunter
VP VBC, Payer, and CORE
Best in KLAS Category
Report Abstract
Key Findings:
- Episource & Veradigm Offer Broad Capabilities & Positive Customer Experience
- Well-Known Vendors Inovalon, Cotiviti & Optum (Limited Data) Falling Behind
- Health Assessments from Vatica Health Offer Unique Approach that Drives Value for Customers
- NLP from Apixio Leads to High Accuracy, Narrow Focus Has Some Customers Looking Elsewhere; Health Fidelity & Talix Customers Experiencing Bumps Post-Acquisition
- Advantmed Sees Increased Customer Satisfaction after Leadership Changes; Ciox Health Often Used for Chart Retrieval but with Some Missed Expectations
- For Analytics, EXL’s Easy-to-Use Offering Aids Customer Utilization; MedInsight & Pareto Intelligence Offer Prospective Capabilities, though Broad Offering Can Add to Complexity
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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.