AutonomizeAI's HEDIS Care Gaps Copilot is designed to identify and address care gaps based on HEDIS measures- it extracts and contextualizes information from patient charts to create concise summaries that help healthcare providers quickly recognize and close these gaps.

Intelligent Care Journeys by Diagnostic Robotics is an AI-powered solution designed to assist care teams in preventing adverse health events, such as hospitalizations, emergency department visits, and the worsening of chronic conditions. It employs predictive models to manage conditions like COPD, diabetes, musculoskeletal issues, and heart failure. The platform also alerts care teams about care gaps, helps prepare for annual wellness visits, and provides data-driven insights for improving care management and spending.

Notable HCC Chart Review uses AI to analyze patient histories – including clinical notes, claims, and other data sources – to identify new and recapture hierarchical condition category (HCC) codes. This system provides evidence-based recommendations to providers during patient visits through EHR integration and supports medical coders, helping improve the accuracy of risk adjustment in both prospective and retrospective HCC workflows.

Inferscience's Infera is a clinical decision support system that integrates with EHRs to provide real-time, evidence-based care recommendations, while their HCC Assistant aids in identifying and documenting HCC diagnoses for improved coding accuracy and maximized Medicare funding

Innovaccer offers a health data platform that centralizes healthcare data and analytics, focusing on patient-centric care. It offers a range of pre-packaged, customizable solutions called Accelerators, as well as applications for improving clinical and financial outcomes. It also provides developer tools for building on the platform.

Affirm Health offers technology to facilitate pre-visit planning and care team collaboration and to support providers in managing care gaps to drive value-based contract performance. They have two primary products, The Huddle and Care Gap Manager. The Huddle is a pre-visit planning tool that synthesizes data for care team collaboration and surfaces opportunities to address care gaps. Care Gap Manager is a tool for analyzing and managing care gaps. These tools support clinics in improving patient outcomes, increasing performance incentives, and lowering medical costs by creating a more efficient workflow. Additionally, Affirm Health customizes its software to align with clinic-specific goals, payer contracts, and workflow needs.

Apixio is a data science company specializing in the analysis of clinical healthcare data and the use of AI to interpret information from various healthcare documents, including unstructured clinical notes. Their platform helps healthcare organizations accurately document and code patient conditions for accurate risk adjustment and reimbursement under value-based contracts. Apixio also aids in quality measure reporting and care gap identification based on healthcare programs.

Arcadia is a health data platform designed for population health management. It specializes in organizing and analyzing clinical and financial data to support improved care delivery and decision-making. The platform features a connectivity layer that manages data inputs from providers and administrators. Additionally, Arcadia provides patient engagement tools, including AI-driven campaign management and outreach programs. With its dual focus on clinical outcomes and financial utilization, Arcadia serves both healthcare providers and payers aiming to optimize population health. Arcadia’s value-based care division was acquired by Guidehealth in December 2023.

Calcium is a digital health platform designed to empower both patients and healthcare providers through personalized care pathways and health data integration. It combines EHR data, device inputs, and behavioral science to offer real-time insights, patient engagement tools, and health management features. Providers can use the platform for better decision-making, while patients receive personalized care guidance through the mobile app. Calcium aims to improve health outcomes by enhancing patient-provider collaboration and data-driven care.

Cedar Gate is a technology company that provides value-based care performance management solutions, from upfront contracting through population health analytics and performance measurement. Cedar Gate provides actuarial services to support with contracting and administration of value-based reimbursement structures such as bundled payments. Their data and analytics solutions integrate data from multiple sources and generate insights to drive care management activities. They work with payers and providers across many specialties and different populations.

Clarify Health's Atlas platform is an enterprise analytics solution with over 15 billion claims in its dataset that can be used for price transparency in contract negotiations, building higher quality networks, reducing spend, and optimizing referrals. The platform aids in optimizing provider performance, reducing medical costs, and improving patient outcomes by integrating social determinants of health and detailed patient data.

Cognizant’s ClaimSphere is a data platform for monitoring and improving quality measure performance. It is an NCQA certified solution for HEDIS reporting and also supports a range of other quality measures. Its products include ClaimSphere Clinical+ for point-of-care supplemental data collection and ClaimSphere QaaS for quality analytics.

Conifer Health Solutions provides revenue cycle management services and value-based care solutions for health systems, provider groups and employers to improve financial outcomes. Conifer’s value-based care solutions include data and analytics tools to support population health management, risk analysis and outcome measurement. They also offer care navigation, care management and utilization management services provided by registered nurses. Conifer Health Solutions is a subsidiary of Tenet Healthcare Corporation.

Cozeva provides a comprehensive operating system for value-based healthcare, supporting the integration of quality, risk, and utilization management. It serves ACOs, IPAs, payers, and providers with tools for predictive analytics, risk adjustment, and real-time data insights to improve healthcare outcomes. Cozeva's platform includes features like CozevaConnect for EHR integration and supports performance metrics like HEDIS and MACRA.

Credo automates the retrieval of medical records for providers and payers. A key feature of Credo is its PreDx service, a pre-encounter medical record and diagnostic tool specifically designed for value-based care providers, particularly in the Medicare Advantage sector. It provides pre-encounter risk analysis and clinical summaries through an AI-enabled analysis of digital medical records, which helps in identifying and closing HEDIS gaps.

Edifecs is a healthcare data interoperability platform that integrates clinical and financial data and provides insights to drive performance in alternative payment models. They also support risk adjustment and prior authorization processes. Edifecs provides solution for health plans, providers and government agencies.

The Episource Clarity Platform is a solution for risk adjustment and quality initiatives for health plans and risk-bearing providers. It supports aspects such as analytics, program management, gap closure, reporting, and CMS submissions. Key components are risk adjustment analytics, a cloud-based data retrieval platform using NLP technology, and tools for accurate coding. The platform aims to enhance performance, compliance, and streamline data management, providing insights for Medicare Advantage, Medicaid, and ACA health plans.

Evidently's Population Health Management solution is designed to improve the health outcomes of specific patient groups by utilizing comprehensive data integration and analysis. The platform aggregates data from various sources, including electronic health records (EHRs), claims data, and social determinants of health (SDoH), to identify at-risk populations and implement targeted interventions. Evidently's PHM tools support risk stratification, care gap identification, and patient engagement, enabling healthcare providers to deliver proactive, personalized care.

ForeSee Medical employs AI and NLP to enhance risk adjustment in healthcare for improved HCC coding and RAF score optimization within EHR systems.

GuideHealth is a value-based care platform that uses AI to predict which patients will need specific care and monitor patient status to avoid preventable events, with virtual health guides to support patient care.

Health Catalyst is a provider of data and analytics technology and services to healthcare organizations. They provide a data and analytics platform that integrates data from multiple sources and delivers insights to support organizations in population health management, patient engagement, quality and safety measure performance, and financial outcomes.

HealthEC offers a suite of data integration and population health management solutions to help healthcare organizations succeed in value-based care. Their platform aggregates data sources to provide comprehensive patient views, support analytics for risk adjustment and care management, and streamline quality reporting. They also provide tools to support care coordination, care management, and patient engagement.

Juxly is a software provider that integrates with EMRs and facilitates provider/payer data integration, and identification and closure of care gaps. Juxly’s EMR app, Juxly Vault, integrates with the provider’s EMR and provides clinical decision support and quality reporting support within the EMR.

Navina is a clinical summarization platform for primary care and value-based care focused on pre-visit chart preparation, accurate risk adjustment, and closing care gaps. Navina converts fragmented patient data into clinical summaries, diagnostic codes, and possible care gaps using data from EHRs, HIE records, patient-provided documents, and scanned documents.

Nuance Performance Analytics is a web-based solution designed to improve clinical and financial outcomes by providing real-time data analytics and decision support. It helps healthcare organizations monitor and analyze performance metrics, including readmissions, patient safety indicators, and physician performance, through customizable reporting and dashboards. The system integrates inpatient and outpatient outcomes to optimize major complications and comorbidities (MCC) and hierarchical condition categories (HCC) capture. It is used by quality management, clinical documentation improvement (CDI) leaders, and patient safety teams to enhance decision-making across healthcare enterprises

Nuna is a data and analytics company that specializes in value-based care performance management and contract and payments administration.

Raapid.ai uses AI and NLP to enhance risk adjustment and coding accuracy in healthcare.

SpectraMedix provides a platform designed to support health plans and health systems in managing value-based payment (VBP) models. Its solutions include VBP Financial Reconciliation for monthly contract reconciliation, VBP Contract Modeler for developing value-based contracts, VBP Analytics Suite for performance insights, and a VBP Provider Portal for providers to track performance and optimize care quality.

Stellar Health is a technology company that helps primary care providers achieve value-based care goals and improve patient outcomes, such as improving quality scores and optimizing the patient care journey through transitions of care and high-value referrals. The Stellar platform is based on incentivizing providers to take real-time actions to improve the quality of care and is designed to facilitate performance in value-based care contracts.

Vatica Health provides a provider-centric solution for risk adjustment and quality of care, pairing clinical teams with technology to enhance coding accuracy and compliance at the point of care.

Vim is a technology company that specializes in surfacing data at point-of-care to drive provider performance and value-based care outcomes. Vim’s platform integrates with the provider EHR and surfaces insights such as diagnosis opportunities for risk adjustment, care gaps for quality scoring, and referral opportunities. Their solutions are also built on provider-payer connectivity, optimizing processes such as eligibility and prior authorization.