RISE Association Partners

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.

Advantmed

Advantmed is a healthcare solutions company dedicated to helping health plans, provider groups, and risk-bearing entities optimize revenue and improve quality outcomes. We achieve industry leading results through a suite of integrated prospective and retrospective solutions that support Medicare, Commercial, and Medicaid populations. Our solutions include:

• Health Assessments (virtual and in-home)
• Risk Adjustment Analytics
• Medical Record Retrieval
• Risk Adjustment Coding
• Second Level Coding Review
• Claims and Data Validation
• Clinical Abstraction
• NCQA-certified HEDIS measure software (certified since 2007)
• Provider Portal

For more information, visit www.advantmed.com or email marketing@advantmed.com.

Apixio

Apixio is advancing healthcare with data-driven intelligence and analytics. Our artificial intelligence platform for value-based care gives organizations across the healthcare spectrum the power to mine clinical information at scale, creating novel insights that will change the way healthcare is measured, care is delivered, and discoveries are made. Learn more at apixio.com.

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.

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

Ciox

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.

Cotiviti

Cotiviti is a leading solutions 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, consumer engagement, and network performance management programs. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit https://hubs.ly/Q01z-zYg0.

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

GeBBS Healthcare Solutions

GeBBS Healthcare Solutions is a leading provider of Risk Adjustment and HEDIS services to healthcare payers and risk bearing providers. As an HITRUST & SOC 2 Type 2 certified organization, GeBBS utilizes its innovative AI enabled technology, combined with over 13000+ experienced workforce, to help clients improve reimbursement , adhere to compliance, measure performance, and enhance the patient experience.

Contact us today at www.gebbs.com to schedule a free technology demonstration or consultation and learn how we can help you address your current challenges and grow into the future.

Inovalon

Inovalon is a leading provider of cloud-based software solutions empowering data-driven healthcare. The Inovalon ONE® Platform brings together national-scale connectivity, real-time primary source data access, and advanced analytics to enable improved clinical outcomes and economics across the healthcare ecosystem. The company’s analytics and capabilities are used by more than 20,000 customers and are informed by the primary source data of more than 71 billion medical events across one million physicians, 622,000 clinical settings, and 359 million unique patients. For more information, visit www.inovalon.com.

Real Time Medical Systems

Real Time Medical Systems, the industry-leading Interventional Analytics platform, provides Health Plans and Payers with post-acute interoperability. The cloud-based solution improves member outcomes by offering live post-acute data transparency that reduces rehospitalizations 52%, decreases length-of-stay 43%, establishes centralized infection surveillance, and risk stratifies members in the PAC-setting. For more information, visit realtimemed.com or you may contact us at info@realtimemed.com.

Reveleer

Reveleer is a healthcare technology company that uses Machine Learning and Intelligent Automation to empower payers in all lines of business to take control over their Quality Improvement and Risk Adjustment programs. The Reveleer platform enables payers to independently execute and manage every aspect of provider outreach, retrieval, coding, abstraction, and reporting – all under one platform. Leveraging proprietary technology, robust data sets, and subject matter expertise, Reveleer also assists payers with full record retrieval and review services to support financial performance and improved member outcomes. Have questions? Contact our experts to learn how we can help: PayerCommunity@reveleer.com

Signify Health

Signify Health is a leading healthcare platform that leverages advanced analytics, technology, and nationwide healthcare provider networks to create and power value-based payment programs. Our mission is to transform how care is paid for and delivered so that people can enjoy more healthy, happy days at home. Our solutions support value-based payment programs by aligning financial incentives around outcomes, providing tools to health plans and healthcare organizations designed to assess and manage risk and identify actionable opportunities for improved patient outcomes, coordination and cost-savings. Through our platform, we coordinate what we believe is a holistic suite of clinical, social, and behavioral services to address an individual’s healthcare needs and prevent adverse events that drive excess cost, all while shifting services towards the home. For more information on how we are taking health homeward, visit us at signifyhealth.com 

Veradigm

Veradigm Payer Analytics (formerly Pulse8) is healthcare analytics and technology solution delivering complete visibility into the efficacy of your Risk Adjustment, Quality, and Pharmacy Benefit Management programs. Veradigm empowers 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. 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. Veradigm's patented Dynamic Intervention Planning offers a suite of uniquely pragmatic solutions that identify 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 email payersolutions@veradigm.com

EXL

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 teams collaborate with our clients to transform how healthcare is delivered, managed and paid.  With data on more than 260 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

LetsGetChecked

LetsGetChecked is a global healthcare solutions company that provides the tools to manage health from home through direct access to diagnostic testing, virtual care, and medication delivery for a wide range of health and wellness conditions. LetsGetChecked’s end-to-end model includes manufacturing, logistics, lab analysis, clinician support, and prescription fulfillment. The company empowers people with accessible health information and care to live longer, happier lives.

To date, LetsGetChecked has delivered ten million tests and served more than 300 corporate customers with testing services and biometric screening solutions since it was founded in 2015.

LetsGetChecked is available nationwide in the United States, the United Kingdom, and most EU countries. It is co-headquartered in Dublin and New York.

Navina

Navina uses medically-informed AI to provide data mastery to primary care physicians.  We transform care - and deliver optimized value-based outcomes - by highlighting care and risk gaps and allowing physicians to instantly find the information they need, and act in the moment of care. The results: higher quality care, elevated physician satisfaction, accurate diagnosis capture, and enhanced financial performance for providers and payers.

Wolters Kluwer

Standard setters in clinical data optimization, Health Language delivers the kind of confidence that transforms health data and healthcare. Time tested and trusted, its easy, accurate, and actionable solutions are a catalyst for customer and patient results. Powered by the Wolters Kluwer engine, Health Language’s deep domain expertise is grounded in know-how and elevated in data transformation that’s clean, clear, and precise. Enablers of assurance, Health Language translates more than data—it turns confusion and complexity into competence and confidence. The experts clients need for the effectiveness they want, Health Language increases operational efficiency and takes its clients from unstructured data to outstanding outcomes.

Vatica Health

Vatica Health is the leading PCP-centric risk adjustment and quality of care solution for health plans and health systems. By pairing expert clinical teams with cutting-edge technology at the point of care, Vatica increases patient engagement and wellness, improves coding accuracy and completeness, facilitates the identification and closure of care gaps, and enhances communication and collaboration between providers and health plans. The company’s unique solution helps providers, health plans, and patients achieve better outcomes, together. Vatica Health is trusted by many of the leading health plans and thousands of providers nationwide. For more information, visit https://vaticahealth.com/

IQVIA NLP

The IQVIA NLP Risk Adjustment Solution combines 20 years of leading Healthcare NLP with Risk Adjustment specific clinical intelligence and workflow. Having supported our clients implement the power of IQVIA NLP (formerly Linguamatics) into their own Risk Adjustment programmes, we now offer a solution that goes from record ingestion through to code acceptance and submission, while providing crucial supporting evidence information to the coder. As a leading provider of Healthcare NLP – our technology also enables organizations to extract additional insights for further applications from the increasing volume of unstructured member data that they are receiving. From identify member level social determinants in health from medical records, to analyzing call center transcripts, there are many additional ways HCOs can benefit from IQVIA’s enterprise NLP capabilities.

Nuance

Nuance Communications is a technology pioneer with market leadership in conversational AI and ambient intelligence. A full-service partner trusted by 77 percent of U.S. hospitals and over 75 percent of the Fortune 100 companies worldwide, Nuance creates intuitive solutions that amplify people's ability to help others. Nuance is a Microsoft company. 

Nymbl

One in three older adults fall each year, costing medicare and medicare advantage plans over $60 billion. Nymbl is the first evidence based scalable fall prevention solution proven to help older adults reduce their risk of falls. Nymbl's digital fall prevention program is helping medicare advantage plans lower fall related emergency room visits and hospitalizations, resulting in significant savings while also improving STAR ratings. Join us on our mission to prevent 1M falls and prove that aging is not less!

Semler Scientific

Semler Scientific’s mission is to develop, manufacture and market innovative products and services that assist our customers in evaluating and treating chronic diseases. The QuantaFlo® 5 is easy to use, accurate, point of care, non-invasive solution for patients at risk for Peripheral Vascular Disease (PAD) and Cardiovascular Disease (HD).

QuantaFlo PAD aids in early detection of Peripheral Arterial Disease (PAD). As published in the Journal of Vascular Surgery and the American Journal of Preventative Medicine, QuantaFlo detected undiagnosed PAD in 31.6% of patients 65 years and over.

QuantaFlo HD, aids in the early detection of “hemodynamically significant” cardiovascular disease. As published in the Journal of Preventive Medicine, QuantaFlo showed a statistically significant correlation with cardiac echocardiography, which is a gold standard for diagnosing heart failure.

Semler has a suite of solutions that wholly integrate our technologies with our customers’ clinical and operational networks: SemlerConnect™, SemlerShield ™, SemlerVault™, SemlerSimulation™, SemlerAnalytics™ and SemlerHub™.

In both cases, QuantaFlo 5 supports stratification of patient care allowing for further cardiovascular risk management.

Note: QuantaFlo is the product name, ‘5’ is the software version, ‘PAD’ and ‘HD’ are applications.

Vital Data Technology

Vital Data Technology® is a data science-driven healthcare solutions company giving payers, providers, and members the power to drive efficiencies and improve clinical and financial outcomes throughout the healthcare ecosystem with their proprietary artificial intelligence-enabled platform, Affinitē™. The platform transforms data into actionable insights using artificial intelligence and advanced analytics integrated with embedded HEDIS® and risk adjustment logic. Affinitē is purpose-built and flexible, deployed as a cloud-based, end-to-end solution or as distinct modules listed below to help with your business needs.

Vital Data Technology is a trusted partner of health plans serving Medicare Advantage, Medicaid, Commercial and Self-Funded populations nationwide and offers data science analysis services in addition to Affinitē. With Affinitē as a single source of truth, all healthcare parties can coordinate more efficient care interventions with a true 360-degree view of the member.

For more information, visit https://vitaldatatechnology.com/.

Zeiss

Carl Zeiss Meditec, Inc. has been a leading provider of ophthalmic diagnostic solutions for over 111 years. Leveraging their industry leading experience, Zeiss is pleased to present the VELARA Teleretinal Screening System for the use of diabetic retinal screening in primary care and other non-traditional eye care settings. Diabetic Retinopathy is the leading cause of blindness in working age adults in America. Expanding the access and availability of screening solutions such as VELARA is one step towards ending preventable blindness. Featuring an easy-to-use automated retinal camera and remote grading application, VELARA enables healthcare organizations to seamlessly close care gaps, improve their quality measures, and provide a higher level of diabetic care. An analytics dashboard provides real-time operational visibility alongside our dedicated customer success team that is here to work with you on an on-going basis to ensure program success. To learn more about how VELARA can support your efforts to provide the best quality care for your diabetic patients, please visit our website at https://www.zeiss.com/meditec/us/product-portfolio/zeiss-velara.html or contact our listed representative. 

3M

3M Health Information Systems empowers payers, providers and government agencies to anticipate and navigate the evolving health care landscape. 3M is committed to creating more time to care and is leading the shift to value-based care. 3M is reimagining data analytics to connect outcomes and behavior, opening the door to valuable insights and sustainable improvements. For more information, visit www.3m.com/his or follow @3MHISNews on Twitter.

Alivi Health

Alivi Health is a licensed Third-Party Administrator who helps health plans manage supplemental and value-based insurance design benefits like non-emergency medical transportation, flex card, SSBCI, food, hearing, vision, dental, OTC, therapy, podiatry, chiropractic, and acupuncture. 

Alivi’s primary benefit is non-emergency medical transportation, where using flexible technology, compliant processes, and experienced people, we guarantee industry leading performance and member satisfaction, with a smooth implementation. Alivi’s benefits are purpose-built to address Social Determinants of Health while creating Health Equity, deliver a delightful Member Experience, promote Member Engagement, and create Competitive Advantage to attract new members and retain existing ones.

For more information, visit www.alivi.com  

Care Coordination Systems

Care Coordination Systems has been advancing community-based care coordination across the nation for more than a decade. Connected people and responsive systems make change possible – so we built the most adaptive technology and effective training in the country. The results are clear: CHWs trust us to help them eliminate barriers, care teams are improving outcomes through real-time data, and organizations have received more than $30M+ in value-based payments to make health equity a measurable reality.

Trusty.care

Trusty.care is improving the way insurance is bought, sold, and managed for the 150m Americans that don’t get their insurance through an employer. Trusty Select Pro streamlines the sales, commission, licensing and contracting process for insurance distributors while significantly improving member retention for payers and providers. The inefficiency of health insurance distribution contributes to 40% rapid disenrollment from insurance policies, with 85% of Americans accessing non-employer based insurance purchasing a wrong-fit insurance plan, and distributors spending 3x the national average on administrative costs.

Trusty.care is on a mission to make sure no American goes bankrupt because of out-of-pocket healthcare costs and we make that happen with our state-of-the-art distribution and member retention platform that is revolutionizing the way insurance is bought, sold, and managed in the $2T Medicare, Medicaid, and ACA markets.