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.

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.

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, and network performance management programs. Cotiviti’s healthcare solutions are powered by Caspian Clarity, a proprietary data and analytics platform spanning thousands of unique member and provider data types across financial and clinical domains, representing the most comprehensive longitudinal data set in healthcare. The company also supports the retail industry with data management and recovery audit services that improve business outcomes. For more information, visit www.cotiviti.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

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.

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 all 25 of the top 25 U.S. health plans, all 25 of the top 25 global pharma companies, 24 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, 580,000 clinical facilities, 336 million Americans, and 62 billion medical events. For more information, visit www.inovalon.com.

Matrix Medical Network

Matrix Medical Network has provided expert care and health services to millions of at-risk individuals where they live and work for more than 20 years. The organization’s network of approximately 5,000 clinicians meets individuals wherever they are to assess their health and safety, identify and close care gaps, and offer life-changing services that activate them to manage their own health. Matrix, in partnership with its expert clinical advisory panel, offers customizable solutions across four distinct lines of business via in-home visits, telehealth, on-site support at medical facilities and businesses, and mobile health clinics: Matrix Clinical Care helps seniors and other at-risk individuals enjoy a better quality of care, experience better health outcomes, and identify chronic conditions that may otherwise go undiagnosed. Matrix Clinical Solutions helps keep workers healthy and businesses run productively by designing custom workplace health solutions and providing testing, tracing, and clinical care solutions. Matrix Clinical Trials provides rapid and scalable decentralized trial solutions to reach broad and diverse trial participant populations and improve the patient experience. Matrix Clinical Labs is a CLIA-certified and CAP-accredited laboratory that provides state-of-the-art diagnostic services and clinical testing support. For more information, visit www.matrixmedicalnetwork.com

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 85 percent of the Fortune 100 companies worldwide, Nuance creates intuitive solutions that amplify people's ability to help others.

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 email Info@Pulse8.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, you may contact us here

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.

Edifecs

Edifecs is a premier technology company in the US Healthcare market with solutions focused on interoperability, workflows, value-based care payments and analytics. With innovative technology and solutions, Edifecs helps its customers by optimizing the secure exchange and processing of administrative and clinical data, reducing the cost of meeting various regulations, and automating workflows involved in multiple core processes within the healthcare ecosystem. Edifecs is a frontrunner in bringing new technology for B2B data exchange in healthcare streamlining business processes from “card to care,” and reducing the industry burden associated with data provisioning at the points of enrollment, care, payment, and reporting. With the advent of FHIR and new regulatory guidance from HHS, Edifecs has emerged as a leader in easing the effort associated with achieving compliance with new federal rules and in making the healthcare consumer the primary stakeholder. The company is headquartered in Bellevue, Washington, with additional offices in Atlanta, Georgia and Mohali, India, an engineering center in Moldova, and has more than 600 employees.

Messagepoint

Messagepoint enables business users to control the creation and management of all member communications.  The Healthcare Touchpoint Exchange provides a purpose-built solution that simplifies the creation and management of regulated Medicare marketing materials (ANOC, EOC, and SB).  It provides access to the framework that includes all model content, PBP data integration and benefit rules. Messagepoint provides a collaborative environment controlled by an integrated workflow that enables stakeholders to participate in a controlled experience when performing annual updates.  Messagepoint’s automation capabilities improve speed, accuracy of information, and compliance with CMS marketing guidelines.  The result is reduced time and effort by as much as 70%, while reducing costs, improving quality and gaining confidence that your plan documents are compliant.

Shearwater Health

Shearwater Health knows that you want quality outcomes without exhausting clinical resources or paying a premium to hire seasonal clinicians. To achieve this, you need your clinicians practicing at the peak of their license. The problem is a nursing shortage that causes rising labor costs and retention issues.

We believe outsourcing your clinical workflows should make life easier. We understand that you want a strategic solution that supports your internal efforts. That’s why we provide remote teams of cross-trained nurses that become an extension of your clinical and quality departments.

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.

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 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

InterSystems

InterSystems is the engine behind the world’s most important applications. In healthcare, business, government, and other sectors where lives and livelihoods are at stake, InterSystems is the power behind what matters™. Founded in 1978, InterSystems is a privately held company headquartered in Cambridge, Massachusetts (USA), with offices worldwide, and its software products are used daily by millions of people in more than 80 countries. For more information, visit InterSystems.com.

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

Equality Health

Equality Health is a new approach to primary care that enables independent physicians to achieve value-based payment success by way of technology deployment, rigorous on-site practice transformation, and incentive programs uniquely designed to reward behaviors that enhance quality, efficiency and overall member experience.