Effective utilization of all data sources improves confidence levels and offers new visibility into your membership, thereby improving financial performance and reducing costs.
Analytics inform us where to focus limited resources. Predictive modeling identifies specific factors associated with natural gap closure. Event Sequencing tools simplify temporal patterns affecting natural gap closure. Low-confidence cases are identified in order to avoid pursuing wasteful and unnecessary interventions.
Pulse8 provides actionable data in real-time, tracking performance against expectations and key milestones. Unbiased. Our Visualization & Reporting measures the latest interaction, creating real-time ROI projections and transparency across the supply chain.
Health Plans and At-Risk Providers utilize the Illumin8 platform for unprecedented visibility into the efficacy of outcomes and removal of considerable waste from the system.
Illumin8 is the only Visualization & Reporting platform that risk-bearing entities need to master the intertwined worlds of Risk Adjustment and Quality Metrics for all government programs: ACA Commercial, Medicare Advantage, and Managed Medicaid.
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.
Qualit8 facilitates gap closure in Star Rating, QRS, and other quality measures using advanced analytics and predictive models to identify and prioritize the quality gaps most worthy of attention and to recommend the ideal intervention method and timeline for closing each.
Valid8 analyzes conditions at risk of failing a data validation audit, whether or not they have been submitted to the EDGE server, CMS (EDPS/RAPS), or Medicaid (MEDS II), and strips away the “False Positives” that can expose a health plan during a RADV Audit for attributing risk factors that cannot be fully validated from the member’s medical records.
Collabor8 helps health plans and at-risk providers to engage physicians, advance quality initiatives, and deliver provider education, benchmarking, and member-specific alerts for gaps in Documentation, Coding, and Quality – all within a provider’s point-of-care workflow, via an intuitive self-service portal.
Integr8 utilizes advanced IT linkages to unite an ever-growing number of leading Electronic Medical Record (EMR) systems in order to access their expansive data sets, embed advanced analytics into the provider’s workflow, and push alerts directly to the provider for gap closure in the clinical setting.
Popul8 employs advanced Computer-Aided Coding technologies, such as Natural Language Processing (NLP) and Optical Character Recognition (OCR), to enable health plans to more efficiently and accurately find, document, and code those conditions for which their members were treated.
Reconcili8 is an integrated solution for EDPS/RAPS and/or EDGE Server Submissions that enables direct data entry, contains correction utilities, manages and prioritizes exceptions, and provides reconciliation dashboards – all to ensure complete and accurate data submissions.