RISE Association Partners

Inovalon

Inovalon is a leading provider of cloud-based platforms empowering data-driven healthcare. Through the Inovalon ONE^® Platform, Inovalon brings to the marketplace a national-scale capability to interconnect with the healthcare ecosystem, aggregate and analyze data in real time, and empower the application of resulting insights to drive meaningful impact at the point of care. Leveraging its Platform, unparalleled proprietary datasets, and industry-leading subject matter expertise, Inovalon enables better care, efficiency, and financial performance across the healthcare ecosystem. From health plans and provider organizations, to pharmaceutical, medical device, and diagnostics companies, Inovalon’s unique achievement of value is delivered through the effective progression of “Turning Data into Insight, and Insight into Action^®.” Supporting thousands of clients, including 24 of the top 25 U.S. health plans, 22 of the top 25 global pharma companies, 19 of the top 25 U.S. healthcare provider systems, and many of the leading pharmacy organizations, device manufacturers, and other healthcare industry constituents, Inovalon’s technology platforms and analytics are informed by data pertaining to more than one million physicians, 559,000 clinical facilities, 319 million Americans, and nearly 56 billion medical events. For more information, visit www.inovalon.com.

Matrix Medical Network

Matrix Medical Network brings care directly to individuals in home, mobile, and facility settings across the country through its clinical network of over 6,000 providers spanning all 50 states. Matrix providers deliver innovative revenue, quality and care management services in support of the country’s leading health plans and at-risk provider organizations. Leveraging advanced analytics and leading-edge technologies, Matrix achieves unprecedented engagement of plan members and patients to improve quality of care and outcomes, while generating positive impact for healthcare payors. Matrix solutions include risk adjustment, quality gap closure, community and needs assessments, advanced diagnostic testing, care management and post-acute support. Matrix supports populations of all ages from infants to seniors across all plan types including Medicare, Medicaid, Commercial and Exchange.

Pulse8

Pulse8 is a Healthcare Analytics and Technology Company delivering complete visibility into the efficacy of your Risk Adjustment, Quality, and Pharmacy Benefit Management programs. We enable health plans and providers to eliminate waste and achieve the greatest financial impact in the Medicare Advantage, Medicaid, and ACA Commercial markets as well as with Value-Based Payment models for Medicare. Our advanced analytic methodologies and flexible business intelligence tools offer real-time visibility into member behavior and provider performance while also improving efficiency for payers and at-risk providers through high-speed clinical data exchange. Pulse8’s Illumin8 Active Intelligence™ platform offers a suite of uniquely pragmatic solutions that are powered by our patent-pending Dynamic Intervention Planning to deliver the most cost-effective and appropriate interventions for closing gaps in documentation, coding, and quality.  For more company information or to schedule a demo, please Info@Pulse8.com.

Episource

Episource provides a complete and integrated set of services and products to simplify the way Medicare, Commercial and Medicaid health plans manage their Risk Adjustment and Quality programs. We work with health plans and healthcare organizations to absorb the most challenging aspects of program implementation, operations, and management. We simplify by modernizing workflows to better assess the full cycle of Risk Adjustment and Quality programs to improve clinical outcomes and financial performance.

Our services include: Retrospective Chart Reviews, HCC Gaps and RAF Campaign Workflow (epiAnalyst), Encounter Data Error Resolution and Financial Analytics (epiEncounter), HEDIS & STARS Analytics & Reporting, Gaps in Care Reporting, and HEDIS Retrieval & Abstraction. We also offer clinical services such as HRAs (Health Risk Assessments) and NP programs. 

For more company information, please contact Claudia Gallardo at (424) 295-0491, visit us at www.Episource.com, or follow us on Twitter @EpisourceLLC

Cotiviti

Following the Verscend-Cotiviti combination, Cotiviti will be a leading information technology and analytics company that is reshaping the economics of healthcare, helping its clients uncover new opportunities to unlock value. Cotiviti’s solutions are a critical foundation for healthcare payers in their mission to lower healthcare costs and improve quality through higher performing payment accuracy, quality improvement, risk adjustment, and network performance management programs. The company also supports retail and life/legal industries with data management and audit services that improve business outcomes. For more information, visit www.cotiviti.com.

Advantasure

Advantasure is a health technology products and business process services company that improves the performance of health plans and provider organizations in the delivery of government healthcare programs. Through a comprehensive portfolio of products and services, Advantasure enables clients to lower administrative costs, increase reimbursement accuracy and improve the quality of care for their members.

CIOX Health

Ciox Health facilitates and manages the movement of health information with the industry’s broadest provider network. Through our expertise in release of information, record retrieval, and HIM, we improve the management and exchange of health information by modernizing workflows, facilitating access to clinical data, and improving the accuracy and flow of health information.

Apixio

Apixio is the data science company for health care. Apixio’s proprietary artificial intelligence platform extracts and analyzes clinical data in electronic and PDF records, generating deep insights into patient health. These insights feed applications such as HCC Profiler, which uncovers supported HCC codes with speed and accuracy, enabling comprehensive code identification and compliance auditing for Medicare Advantage and ACA programs.

Prognos Health

Prognos Health is a healthcare AI platform company focused on predicting disease to drive decisions earlier in healthcare in collaboration with payers, life sciences and diagnostics companies.The Prognos Registry is the largest source of clinical diagnostics information covering scores of disease areas, with billions of medical records for millions of patients and growing. Prognos has 1,000 extensive proprietary and learning clinical algorithms to enable earlier patient identification for enhanced treatment decision-making, risk management and quality improvement. The company is supported by a $42M investment from Safeguard Scientifics, Inc., Merck Global Health Innovation Fund, Cigna, GIS Strategic Ventures, Hikma Ventures, Hermed Capital, and Maywic Select Investments. Learn more about Prognos at www.prognoshealth.com

GeBBS Healthcare Solutions

GeBBS Healthcare Solutions, Inc., a leading provider of technology-enabled risk adjustment, Quality, revenue cycle management, and revenue integrity solutions. GeBBS leverages proprietary technology, flexible engagement models, best-in-class processes and first-class infrastructure to offer Health Plans Hospitals and Physicians a platform that reduces costs and improves the bottom line. With a current staff of over 8,000 professionals, GeBBS has been recognized by Modern Healthcare as a Top 15 largest revenue cycle management firm and an eleven-time Inc. 5000 honoree as one of the nation’s fastest growing companies.

GeBBS focuses on Risk Adjustment, HEDIS, and Quality by providing technology enabled solutions for Payers and Risk-bearing providers.

GeBBS Offers One Platform For:

• Risk adjustment and HEDIS
• Concurrent and retrospective
• Chart acquisition and repository
• Tacking/monitoring your RAF score
• Comprehensive provider education
• Single reporting and dashboards

To learn more about our highly efficient HCC coding services and risk adjustment, please call us at (310) 953-4444 or email us at sales@gebbs.com or visit our website www.gebbs.com.

Engagent Health

Engagent Health provides a flexible module based full end to end solution for your sales administration. Our software successfully creates efficient and compliant sales and agent oversight processes through automation and integration between the modules.

Centauri Health Solutions

Centauri Health Solutions is a leading provider of technology-enabled analytics and services helping health plans and health systems to manage their variable revenue linked to population health (risk), quality, and eligibility factors. These efforts result directly in better-informed health care delivery, richer benefits, and reduced out-of-pocket healthcare costs for the members and patients they serve.

Healthify

Healthify builds the infrastructure to support SDoH initiatives at scale. The company offers access to its accountable networks of social service organizations, which are geo-targeted and intervention-focused to ensure that the unique needs of each community are addressed. Healthify also works directly with social service organizations to develop and formalize contracts, ensuring accountability across its networks. Supported by an interoperable SDoH referral platform, partnering organizations can coordinate care with ease, while ensuring their communities are receiving the services they need to thrive.

3M

3M Health Information Systems empowers providers, payers and government agencies to anticipate and navigate the evolving healthcare landscape. 3M is committed to eliminating revenue cycle waste, creating more time to care and bridging the gap from volume to value-based care with innovative software and services. By closing the loop between clinical care and revenue integrity, 3M helps organizations reduce costs and enable more informed care.  For more information, visit www.3m.com/his or follow @3MHISNews on Twitter.

Change Healthcare

Change Healthcare (Nasdaq: CHNG) is a healthcare technology company that provides data and analytics-driven solutions to improve clinical, financial and patient engagement outcomes in the U.S. healthcare system.

We are foundationally committed to fully leveraging Artificial Intelligence to inspire a better healthcare system. We have the synergistic combination of: Massive Data Scale, Market Position & Workflow, Deep Bench of Dedicated Data Scientists, and Infrastructure Investment & Expertise, putting us at the forefront of the industry.
Our interoperable products and AI-driven automation deliver more value with less effort, allowing you to perform tasks more easily. We help you reduce administrative costs, increase your cash flow, and realize a more consistent, profitable revenue stream.

Learn more at www.changehealthcare.com

Talix

Talix provides risk and quality solutions to help providers, payers and accountable care organizations address the growing challenges of value-based health care. Its leading-edge SaaS applications leverage machine learning and advanced patient data analytics to transform complex data into actionable intelligence that drives improved coding efficiency and accuracy – leading to better patient outcomes, more accurate reimbursements and reduced costs.

mPulse Mobile

mPulse Mobile, the leader in Conversational AI solutions for the healthcare industry, drives improved health outcomes and business efficiencies by engaging individuals with tailored and meaningful dialogue. mPulse Mobile combines behavioral science, analytics and industry expertise that helps healthcare organizations activate their consumers to adopt healthy behaviors. With over a decade of experience, 70+ healthcare customers and more than 200 million conversations annually, mPulse Mobile has the data, the expertise and the solutions to drive healthy behavior change.

Healthify

Healthify builds the infrastructure to support SDoH initiatives at scale. The company offers access to its accountable networks of social service organizations, which are geo-targeted and intervention-focused to ensure that the unique needs of each community are addressed. Healthify also works directly with social service organizations to develop and formalize contracts, ensuring accountability across its networks. Supported by an interoperable SDoH referral platform, partnering organizations can coordinate care with ease, while ensuring their communities are receiving the services they need to thrive.

Datalink Software

DataLink is the premier data aggregation, value-based performance management, provider enablement, and point-of-care partner to health plans, MSOs, ACOs, IPAs, medical groups, and provider entities.  DataLink aggregates disparate data sources and systems to create the one source of truth for clients. DataLink illuminates value-based contract performance, MLR impact opportunities, provider network alignment and engagement, care pathways, quality scores, and risk adjustment program excellence. 

Transunion

TransUnion Healthcare, a wholly owned subsidiary of TransUnion, makes mutual trust possible between patients, providers and payers by helping them navigate payment uncertainty. Our Revenue Protection^® solutions leverage comprehensive data, accurate insights and industry expertise to engage patients early, ensure earned revenue gets paid and optimize payment strategies. TransUnion Healthcare helps over 1,850 hospitals and 550,000 physicians collectively recover more than $1.2 billion annually in revenue.

DMW Direct

DMW is a full-service direct marketing agency with over 35 years of experience serving the insurance industry. Today, over 90% of our activity is in the health insurance industry, with a specific emphasis on the varied aspects of Medicare marketing: MA, SNP, and Supplement plans; AEP, OEP and SEP campaigns; plus, year-round New-to-Medicare and Retention programs. Our clients rely on us to create measurable, ROI-driven marketing across all channels: digital, video, print, direct mail, and TV. The agency’s core values focus every daily activity to Inspire Direct Results.

HMS

HMS powers healthcare with integrity through payment integrity, eligibility, and coordination of benefits solutions. HMS's clients include health and human services programs in 45 states and the District of Columbia; commercial payers, including group health plans, Medicare Advantage Plans, and more than 16 Medicaid managed care plans; employers; the Centers for Medicare and Medicaid Services; and the Veterans Administration. As a result of the company's services, clients recover billions of dollars every year and save billions more through the prevention of erroneous payments.

Fox Rehabilitation

With over 21 years of experience, FOX Rehabilitation is an innovative, high-performance, entrepreneurial professional private practice of physical, occupational and speech therapists, built on the strong clinical foundation of Geriatric House Calls™. Our interventions are provided in our client’s homes whether in senior living or in their original home, which we call the community. Specializing in clients with multiple chronic conditions, FOX’s clinically excellent interventions are demonstrated by proven outcomes resulting in downstream savings.

LetsGetChecked

LetsGetChecked is a health insights platform which allows consumers the ability to access health testing and telehealth services in the home. The company provides fast, accurate and confidential home health tests, with online results in a matter of days. Tests cover sexual health, men’s health, women’s health and general health, available to order nationwide.

Letsgetchecked is an innovative partner in digital health space leveraging the consumer-first health trend. Consumer convenience, accessibility and encouragement of regular screening creates a natural partner for Payers seeking to improve Star Ratings and optimize the member experience.

Available in 30 markets globally and nationwide in the US, LetsGetChecked empowers consumers, by making the screening process patient-led. Combining health data and diagnostic results, LetsGetChecked provides accurate insights for patients, enabling them to make better decisions about their health and improve outcomes.

Landmark Health

Since 2014, Landmark Health and its affiliated medical groups (Landmark) have delivered comprehensive in-home medical care to older adults, 24/7 – 365 days a year. Specialized in complex chronic care, Landmark’s physician-led multidisciplinary teams work with patients’ existing healthcare networks to bring medical, behavioral, and palliative care, along with social services, to individuals where they reside. As one of the nation's largest value-based healthcare companies, more than 130,000 people across 17 states and 51 communities can access Landmark’s care.  Most critically, Landmark is bending the cost curve in health care by reducing avoidable ER visits and hospital admissions, while extending the lives of patients. landmarkhealth.org

NPC, Inc

A leader in communications management, NPC, Inc. engineers custom solutions to help keep your stakeholders connected to critical information in times of transition, resilience, and re-imagination. We combine flexibility, security, and accountability to develop tailored workflows that simplify the management of your print, mail, and digital communications programs. A company built around you, NPC works with you to create lasting value for your stakeholders by turning information into tangible opportunities, experiences, and benefits.

Guided Medicare Solutions

Guided Medicare Solutions is a suite of Medicare insurance firms designed to connect our brokers with the expertise and products needed to propel new business success and best serve clients need. We are dedicated to becoming the industry standard in the Medicare insurance advisory field, fueled by relationships and powered by people and technology to deliver indispensable knowledge and innovate health solutions. 

EXL Health

EXL Health combines unmatched healthcare domain expertise with data-driven insights and technology-enabled services to transform how care is delivered, managed and paid. Leveraging human ingenuity, our team’s collaborate with our clients to solve their most complex problems and enhance their performance by employing nimble and scalable solutions. Covering more than 150 million lives, EXL partners with healthcare organizations across the healthcare spectrum including payers, providers, PBM and life sciences organizations.  EXL’s proprietary Risk Adjustment analytics and quality platform and custom services support our clients in driving outcomes and maximize reimbursement. To learn more visit https://www.exlservice.com/health.