Offering a unified solution through one vendor, Veradigm Payer Analytics provides a bidirectional connection that helps ensure end-to-end efficiency. Our approach to risk management optimizes your financial performance while enhancing risk and quality scores, all through one cohesive, easy-to-navigate path.
Veradigm Payer Analytics
Support Your Risk Adjustment & Quality Management Programs
Veradigm Payer Analytics offers a comprehensive suite of solutions that can provide your health plan with complete transparency into the efficacy of your Risk Adjustment, Quality Management, and Pharmacy Programs. These quality and risk adjustment tools are essential for Health Plans and At-Risk Providers as they navigate the complexities of healthcare.
Effective risk adjustment in healthcare is crucial for accurate funding and patient care optimization. Veradigm addresses the needs across various functional areas such as Finance, Actuary, and Pharmacy Program Management, ensuring that every dimension of your healthcare strategy is covered.
Our sophisticated solutions support improved outcomes to the benefit of everyone involved in the cycle of care.
Veradigm Payer Analytics Can Help You
Payer Analytics from Veradigm utilizes cutting-edge risk adjustment software that aligns the right providers at crucial moments.
Close gaps and enhance financial performance
Improve risk and quality scores
Deploy the right intervention, with the right provider, at the right time
Veradigm Payer Analytics is a comprehensive suite of solutions designed to optimize healthcare management and delivery. Each component is tailored to enhance the operational and clinical outcomes for health plans and at-risk providers, helping to ensure a holistic approach to healthcare management.
Risk Adjustment Analytics: Enhance accuracy in patient risk profiling.
Quality Analytics: Improve healthcare outcomes and quality scores.
Risk Mitigator: Support effective risk mitigation in healthcare for RADV audits.
Veradigm Provider Engagement Solutions: Enhance collaboration and efficiency among providers.
eChart Integration and Analytics: Streamline data integration and analysis from EHRs.
Veradigm Coding Technology: Advanced solutions for medical coding accuracy.
Veradigm Comprehensive Submissions: Facilitate efficient data submissions for compliance and reporting.
Explore our suite of healthcare risk management software in more detail to find the best solution for your needs.
Quality Analytics
Uses predictive analytics and Dynamic Intervention Planning to prioritize gap closure efforts for Quality Rating Systems, Star Ratings, and Medicaid.
An NCQA Certified HEDIS engine to help close quality gaps and improve quality scores
Advanced analytics for monitoring, measuring, and reporting on each quality metric — assimilating the data to redirect interventions where needed most
Uses a robust series of analytics dashboards to help health plans deploy impactful Quality Management programs
VERADIGM PROVIDER ENGAGEMENT SOLUTIONS
Provider engagement solution that effortlessly engages healthcare providers, minimizes administrative burden, and boosts overall efficiency.
Provider alerts are supported by our risk and quality analytics solutions
Facilitates bi-directional communication between participating healthcare providers and the gap analytic process
Offers customer configuration for Payers to target the alerts they want to close
Provides access to an educational resource library for a deeper understanding of documenting care management within Risk Adjustment and Quality programs
VERADIGM ECHART CODER
Leverages advanced technologies to produce an accurate and efficient means for identifying and coding members’ conditions.
Computer-assisted Coding (CAC) utilizing Natural Language Processing (NLP) and Optical Character Recognition (OCR) to identify, validate, and prepare for efficient and accurate submission
Optimizes coding workflows to utilize big data and advanced search algorithms on structured and unstructured data
Features an intuitive interface with error-proofing and intelligent audit capability
VERADIGM COMPREHENSIVE SUBMISSIONS
Scalable, flexible, integrated solution to help ensure timely, accurate, complete, and compliant encounters for all government-sponsored programs.
Complete and accurate tracking and status-monitoring of all encounters with end-to-end visibility into member claims data
Workflows configurable for batch corrections, reviews and approvals, and re-submissions to enhance workforce efficiency
Validates 100% of claims data to enable 98%+ acceptance rate
Integration with our industry-leading trading platform to enable seamless EDI channel connectivity
Veradigm healthcare risk management software caters to various markets for risk-adjustment government programs, including those managing Medicare risk adjustment. Learn more about the government programs Veradigm services.
ACA: ACA Commercial / Qualified Health Plans (QHPs)
MA: Medicare Advantage
MEDICAID: Managed Medicaid
DUALS: Dual Eligible
SNP: Medicare Special Needs Plans (SNP)
PCMH: Patient-Centered Medical Homes (PCMH)
ACO: Accountable Care Organizations (ACO)
MACRA: Medicare Access and CHIP Reauthorization Act of 2015 (MACRA)
Looking to learn more about Risk Adjustment & Quality Management solutions?
As part of Veradigm, Koha Health’s services now include advanced support for managing staff, streamlining workflows, ensuring medical coding accuracy, insurance claims submission, and comprehensive reporting. This integration is designed to leverage your existing technology investments and drive meaningful improvements that impact your bottom line. With Veradigm, you gain access to an expanded suite of tools and resources that build a strong foundation for future success. From efficient revenue cycle management to enhanced patient care, Veradigm is committed to supporting your goals now and into the future.
Allscripts is now Veradigm
Allscripts transitioned its solutions to the Veradigm brand, including electronic health records, practice management systems, and patient engagement platforms in 2022. Veradigm is a healthcare technology company that drives value through its unique combination of platforms, data, expertise, connectivity, and scale. The Veradigm Network features a dynamic community of solutions and partners providing advanced insights, technology, and data-driven solutions for the healthcare provider, payer, and life science markets.
Pulse8 is now Veradigm Payer Analytics
Former Pulse8 solutions are now part of the Veradigm Payer Analytics portfolio. In addition to delivering complete visibility into the efficacy of your Risk Adjustment, Quality Management, and Pharmacy programs through former Pulse8 solutions like Calcul8, Qualit8, and others, Veradigm offers a broad range of solutions to help Payers meet their goals for supporting high-quality, cost-effective patient care.
Babel Health is now part of Veradigm
Babel Health solutions are now part of Veradigm Payer Analytics, with enhanced Risk Adjustment (RA) submission workflow creating an end-to-end solution for regional health plans and payers. With Veradigm, Babel clients can receive enhanced support with the ability to leverage a truly end-to-end suite of products and solutions. From RA and Quality analytics and reporting, provider engagement tools, and comprehensive submissions solutions, Veradigm is positioned to support your goals now and in the future.
Evalytica is now Veradigm Real-World Evidence Analytics Platform
Evalytica platform is now part of the Veradigm Network and is known as Veradigm Real-World Evidence (RWE) Analytics Platform , a powerful self-service analytic platform. This transition allows for the advancement of our RWE Analytics technology, expansion of the platform and improvement of its capabilities, functionality, and reach.
