Risk Adjustment

risk adjustment

Improve coding accuracy with Advanced Risk Adjustment

Transform your risk adjustment program with intelligent workflows and real-time insights that improve coding accuracy and patient outcomes.

Robust Risk Intelligence

The Healthcare Intelligence Cloud enables both providers and payers to improve risk scoring accuracy and achieve better care outcomes.

For Providers

Seamlessly integrate risk adjustment into clinical workflows with point-of-care tools that surface suspected conditions, documentation gaps, and clinical evidence.

For Payers

Transform your risk adjustment performance with AI-powered analytics that drive both prospective and retrospective programs.

For payer

Intelligent Risk Capture that Providers Utilize

For provider

Capture Risk Without Disrupting Care

Why Choose Innovaccer for Risk Adjustment?

Proven Results

Clients see up to 30% improvement in coding accuracy, significant reduction in documentation time, and improve risk score accuracy.

Seamless Integration

Innovaccer integrates directly with all major EHRs, automating data ingestion from multiple sources, normalizing the data, and pushing real-time updates.

AI-Powered Intelligence

Our risk adjustment system leverages advanced natural language processing, predictive analytics for suspect condition identification, and machine learning algorithms for continuous improvement.

Population health teams recognize better outcomes with Innovaccer

"Innovaccer is one of those partners that we work with in order for us to get more value out of the data that we have. We have many different EMRs"

Seth Staton

Head of Clinical Programs & Innovations, Walgreens

“Innovaccer's data and analytics platform helps us continue to improve patient health, increase efficiency, and enable physicians to succeed with value-based care”

Camille Wilson

Market VP of Population Health at Arkansas Health Network

improvement in coding and documentation accuracy at

Powered by a unified data model that links disparate data sources

Integrate

Raw data is received from source systems & stored in a data lake.
‍

3X

more accurate than off-the-shelf AI

Harmonize

Data is parsed & codified, then stored in a simple data structure.

3X

more accurate than off-the-shelf AI

Unify

3X

more accurate than off-the-shelf AI

Patient & provider information are aggregated into a single record.

Process

Intelligent algorithms enrich the data with quality measures, gaps in care, & more.

3X

more accurate than off-the-shelf AI

Analyze

Data is denormalized into a structure for analytics & AI.

3X

more accurate than off-the-shelf AI

Integrate

Raw data is received from source systems and stored in the lake before any processing and interpretation. Your original data is always available to diagnose any issues and enable reprocessing as issues are resolved.

Integrating data in 16 states for

2800

data elements supported

Unify

Patient and provider information are aggregated into a single record containing multiple sources of information through Master Data Management functionality, including an Enterprise Master Patient Index, and data curation to remove redundancies. The data at this level is leveraged for application functionality and downstream processing.

Unifying records at

54M

patient records unified

Harmonize

The raw data is parsed and codified, then stored in a simple and clean data structure without complex relational features. The data at this level is typed and coded to the UDM’s ontology and ready to be processed into the downstream structures, which are leveraged for applications and analytics.

Harmonizing clinical and claims data at

6000

data quality rules applied

Process

Intelligent algorithms enrich the data the previous stage with deep insights. Out of the box, this includes each patient’s disposition toward quality measures (numerator, denominator, exclusions), risk and social vulnerability profiles, gaps in care, engagement data, next best actions, and more.

Improving documentation accuracy at

10%

improvement in quality gap closure

Analyze

Analytics summarize and denormalize the data from Unify and Process stages into a multidimensional data cube structure optimized for analytics, AI, workflows, and additional data visualization use-cases.

Bringing analytics and AI to

22%

reduction in readmission rates

integrations

Unlocking your EHR’s full potential

Population Health Analytics integrates seamlessly with your EHR(s) to create a system-wide population health strategy. That's why the largest customers of Epic, Oracle Cerner, and MEDITECH choose Innovaccer.

An integral part of the value-based care suite

Quality management

Align payers, providers, pharmacies, and members to drive measurable improvements in quality performance.

Care Management

Innovaccer's Care Management Copilot uses advanced AI to automate documentation, generate care insights, and predict patient risk.

Contract management

Build predictable revenue models, strengthen contract negotiations, and maximize financial performance in value-based care.

Population Health Analytics

Population Health Analytics leverages the full power of the Data Activation Platform to deliver actionable insights that drive performance in value-based care.

Frequently Asked Questions

How does Innovaccer improve coding accuracy?

Our platform analyzes both structured and unstructured data from multiple sources (EMRs, claims, labs, etc.) to identify potential missed conditions with supporting evidence. The system learns from coding patterns and clinical documentation to detect gaps with up to 95% accuracy. This comprehensive analysis ensures more accurate HCC capture while reducing the risk of overcoding or documentation errors.

Can the solution integrate with our existing EMR system?

Yes, our Risk Adjustment solution seamlessly integrates with all major EMR systems including Epic, Oracle Cerner, MEDITECH, and others. We offer bidirectional integration that enables automatic data ingestion and the ability to write back accepted coding gaps directly into your EMR. This integration eliminates duplicate documentation and maintains a single source of truth for clinical information.

How long does implementation typically take?

Implementation timeframes vary based on your organization's size and technical environment, but typically range from 8-12 weeks. Our experienced implementation team handles data integration, workflow configuration, and user training. We use a phased approach to ensure minimal disruption to your operations while achieving quick wins in the first 30 days.

How does the solution support RADV audit preparation?

Our platform maintains comprehensive audit trails and documentation evidence for all coding decisions. The concurrent review workflow ensures proper validation before claims submission, while our AI engine flags potential documentation gaps or inconsistencies. This proactive approach typically reduces audit exposure by over 60% and significantly improves audit outcomes.

How does the solution handle provider feedback and queries?

The platform includes a built-in provider query system that streamlines communication between coders and providers. Providers receive notifications within their workflow and can respond directly in the system. Our data shows this integrated approach reduces query response times by 50% and improves documentation quality on the first submission.

What training and support do you provide?

We provide comprehensive training and support including:
Initial user training for all roles (physicians, coders, administrators)
Ongoing monthly best practice sessions
24/7 technical support
Dedicated customer success manager
Regular performance review meetings
Access to our online knowledge base and user community

Learn how to unlock the full potential of your healthcare data

whitepaper

Innovaccer’s Data Activation Platform: What Makes it the Best in KLAS Data and Analytics Platform

whitepaper

Five Reasons Why the Modern Payer Needs a Data Activation Platform

Demo Advanced Risk Adjustment today