Case Studies

Providers are facing a significant challenge as they transition from fee-for-service to pay-for-performance care. To navigate this shift smoothly, they need to upgrade their technology stack to ensure financial and operational stability.

Franciscan Alliance is one of the largest Catholic healthcare systems in the Midwest. Their aim has always been to deliver quality- and patient-centered care across populations including Medicare Advantage, MSSP, and commercial populations.

The sheer volume of manual documentation and paperwork required for medical coding increases the risk of error, leading to improper payments after claims reimbursement. More than 100 million medical records are reviewed every year in the US, and providers are continually looking for more efficient ways to ensure accurate HCC coding.

As health systems move toward value-based care, improving transitional care is critical. A data-driven approach to risk and readmission management results in better outcomes and decreased hospital costs—a win-win for the health system and the patient.