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
Ryan Pretnik
Research Director
Best in KLAS Category
Recent Insights
Key Findings:
- Vendor Snapshots & Customer-Validated Usage
- Inovalon and Optum Are Compelling for Their Comprehensive Offerings but Fall Short in Meeting Expectations
- EXL’s Strong Analytics Offering Expanding to Broader Capabilities; Advantasure’s Technology Lacking
- Apixio’s AI Capabilities and Client Success Program Drive Accuracy, Efficiency; Health Fidelity’s Difficult Implementations Causing Struggles
- Pulse8 & Optum Customers Most Likely to Consider Leaving
- Pareto’s Analytics and Proactive Partnership Lead to High Satisfaction; Overall MedInsight Experience Improving
- Risk Adjustment Pillar Definitions
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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.