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.

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.

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.

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.

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 Advance is an incentive program for providers in at-risk arrangements. The product is geared to health plans and includes administrative functions such physician recruitment, contract management, performance monitoring, and payment.

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.

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.

Curation Health offers a clinical decision support platform tailored for the transition from fee-for-service to value-based care models. Designed to integrate with EHRs like Allscripts, athenahealth, and Epic, the platform delivers in-EHR insights to healthcare providers and plans for more accurate risk adjustment and improved performance in quality programs.

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.

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.

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.

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.