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 994,000 physicians, 558,000 clinical facilities, 315 million Americans, and 55 billion medical events.

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.

Optum

Optum is a leading health services and innovation company dedicated to helping make the health system work better for everyone. With more than 124, people worldwide, Optum combines technology, data and expertise to improve the delivery, quality and efficiency of health care. Optum uniquely collaborates with all participants in health care, connecting them with a shared focus on creating a healthier world. Hospitals, doctors, pharmacies, employers, health plans, government agencies and life sciences companies rely on Optum services and solutions to solve their most complex challenges and meet the growing needs of the people and communities they serve.

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.

Change Healthcare

Change Healthcare is inspiring a better healthcare system.  Change Healthcare is a key catalyst of a value-based healthcare system – working alongside our customers and partners to accelerate the journey toward improved lives and healthier communities. While the point of care delivery is the most visible measure of quality and value, we are a healthcare technology solutions company that uniquely champions the improvement of all the points before, after, and in-between care episodes. With our customers and partners, we are creating a stronger, better coordinated, increasingly collaborative, and more efficient healthcare system that enables better patient care, choice, and outcomes at scale.

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.

Signify Health

About Signify Health

Signify Health is helping build the healthcare system we all want to experience by transforming the home into the healthcare hub. We coordinate care holistically across individuals’ clinical, social, and behavioral needs so they can enjoy more healthy days at home. By building strong connections to primary care providers and community resources, we’re able to close critical care and social gaps, as well as manage risk for individuals who need help the most. This leads to better outcomes and a better experience for everyone involved. 

Our high-performance networks are powered by more than 9,000 mobile doctors and nurses covering every county in the U.S., 3,500 healthcare providers and facilities in value-based arrangements, and hundreds of community-based organizations. Signify’s intelligent technology and decision- support services enable these resources to radically simplify care coordination for more than 1.5 million individuals each year while helping payers and providers more effectively implement value-based care programs. 

To learn more about how we’re driving outcomes and making healthcare work better, please visit us at www.signifyhealth.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.

Edifecs

Edifecs develops innovative, cost-cutting information technology solutions to transform the global healthcare marketplace. Since 1996, Edifecs technology has helped healthcare providers, insurers, pharmacy benefit management companies and other trading partners trim waste, reduce costs and increase revenues. More than 350 healthcare customers today use Edifecs solutions to simplify and unify financial and clinical transactions. In addition, Edifecs develops supply chain management solutions to support worldwide customers in non-healthcare industry segments. Edifecs is based in Bellevue, WA, with operations internationally. Learn more about us at www.edifecs.com.

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.

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. 

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.

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.