Financial Impact Analytics for ACOs

Accurate Risk Adjustment: Each patient is aligned to the correct CMS eligibility model (e.g., ESRD, Disabled, Aged Non-Dual, Aged Dual) to improve RAF accuracy and reflect true population risk.

Granular Visibility Across Your Population: Drill down from enterprise to provider to patient level to identify which providers and patients are driving cost, risk, and financial performance.

Scenario-Based Performance Modeling: Use pre-built scenarios based on historical performance and current HCC data to project outcomes and evaluate potential impact.

Actionable Risk and Performance Insights: Identify high-impact patients and providers to support earlier intervention, provider engagement, and network optimization.

Multi-Level Performance Visibility: Track performance across ACO, group, practice, provider, and patient levels to identify variation, financial risk, and opportunities for improvement throughout the performance year.

Measure Intervention Impact Over Time: Monitor the effectiveness of interventions and evaluate progress throughout the year to understand what’s improving performance and where corrective action may be needed.

Flexible Claims, Visit, and Service Line Analysis: Analyze trends at the visit level for high-level patterns or drill into claims, DRGs, and service lines to understand the specific drivers behind cost and utilization changes across both Medicare and commercial populations.

Row-Level Drilldown to Source Data: Move instantly from summary trends to the underlying claims or visits with pre-applied filters, helping teams validate findings, answer questions faster, and act with confidence.