Calcul8 delivers the real-time visibility needed to monitor and manage risk adjustment revenue against budgeted gap closures and Key Performance Indicators (KPIs). Calcul8 allows a plan’s risk adjustment and revenue management leadership team to make data-driven decisions on intervention strategies, so as to ensure accurate reimbursement, optimal resource deployment, and coordination between revenue and quality management. Most notably, through Calcul8, Pulse8 is the only vendor thoroughly illuminating areas of administrative funding waste and efficiently directing your intervention investment.
The key to optimal interventions lies in our Dynamic Intervention Planning. This uniquely empowers our clients to tailor the intensity, timing, and type of intervention in accordance with the characteristics of each particular opportunity – and to modulate or escalate those interventions as the data unfold throughout the year. Thanks to Dynamic Intervention Planning, our clients avoid chasing the wasteful tails and instead focus on identifying the right member at the right time for the right intervention.
Whether running an ACA Commercial, Medicare Advantage, or Medicaid program, Calcul8 is the ultimate tool for enabling you to accurately project the RAF points, HCCs, or Condition Types needed to achieve budget and the intervention type, level, and timing with which to get there. Calcul8 enables users to drill down to the individual Provider/Group, Contract/PBP, and Metal Level. Calcul8 provides the most precise Transfer Payment Revenue Projections (TPRP) within the ACA Commercial market, Mid-Year and Final Year Risk Adjustment impact analyses (MYRA and FYRA) within Medicare Advantage, and Annual True-Ups on Retroactive Rate Adjustments in Medicaid.
Calcul8 is the financial instrument that helps risk-bearing entities to navigate the complexity of financial reporting, while avoiding the pursuit of unnecessary and wasteful gap closure activities.