Reveal8

Risk Adjustment Analytics

Combining the most precise, confidence-adjusted Risk Adjustment Algorithms with the most efficient Gap Closure methodologies

Pulse8’s flagship product, Reveal8, delivers the most advanced risk adjustment analytics to the ACA Commercial, Medicare Advantage, and Managed Medicaid markets.  Using Big Data mining, clinical inferencing, and multiple predictive models, we deliver the most precise risk adjustment algorithms to ensure that our clients outperform their competitors.

Key features of the analytic engine that delivers the greatest risk-adjusted returns:

  • Financial Risk Factor and unique member profiling
  • Real-time visibility into your population Risk Factor
  • Differentiated approach to gap closure depending upon whether the condition is “Persisting” or “Suspecting”
  • Eliminate interventions that are unlikely to bear fruit
  • Risk Adjustment and Quality gap closure in one coordinated effort
  • Transparent and flexible visualization and reporting tools

Reveal8 leaves no stone unturned by leveraging a vast array of information, including medical and pharmacy claims, lab results, care management data, health risk assessments, medical records, and “off the data grid,” non-traditional information.  Reveal8 then determines the confidence level on all inferences by reviewing member and provider behavior patterns, along with the frequency, potency, and reliability of each data source.

After calculating “confidence-adjusted” risk scores, Reveal8 prioritizes all possible opportunities and recommends the optimum intervention strategy for efficiently closing each documentation, coding, and quality gap deemed worthy of pursuit.

In summary, Reveal8 couples the most effective Gap Identification methodology with the most efficient Gap Closure strategy to ensure that our clients pursue the right member and provider with the right intervention at the right time.  We “tailor our touches” to optimize your gap closure rates and risk adjustment ROI.

As the analytic engine driving all that we do, Reveal8 is the foundational product enabling Pulse8 to provide risk-bearing entities with the most pragmatic gap closure solution available anywhere.

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For all general and sales inquiries, please contact us at 410.928.4218 or email us at info@pulse8.com
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