360° Gap Closure Solutions to Advance Risk, Quality & VBC Outcomes
A single, AI-powered platform for health plans to close quality gaps, improve risk score accuracy, and reduce administrative burden.
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The only integrated payer platform to drive quality, risk, and outreach

The Healthcare Intelligence Cloud enables payers to centrally deploy value-based care programs to pharmacies and providers nationwide.
Drive provider and pharmacy quality
Leverage the largest national network of pharmacies and providers to close care gaps, improve quality metrics, and deploy value-based care programs.
Improve risk score accuracy
Accelerate accurate risk capture with point-of-care tools that identify coding gaps and opportunities across your provider network.
Increase member engagement
Drive better outcomes through personalized, omnichannel engagement that meets members where they are with the right message at the right time.

End-to-end integrated workflows across 
office, pharmacy, and home

Member

A one-click, ordering platform for in-home test kits, designed to improve quality outcomes through preventive care.

Supports easy ordering, fulfillment, lab processing, and data collection.

Enhances member engagement with reminders, tracking, and automated follow-ups.

Addresses gaps in screenings and preventive health measures.

Pharmacy

Unlock insights for pharmacies to close gaps and ensure medication adherence.

Leverages the largest pharmacy network to integrate pharmacies into value-based care strategies.

Supports immunizations, medication adherence, and screenings at pharmacy locations.

Enables real-time reporting on member engagement and outcomes.

Practices

Personalized member engagement and care coordination with an AI-powered member data platform.

Automates multi-channel outreach (email, SMS, phone, digital campaigns).

Enhances provider-payer collaboration by delivering actionable insights.

Supports real-time communication between payers and members.

Chart Retrieval

A medical record retrieval, coding, and abstraction solution with AI-powered automation.

Enables prospective, concurrent, and retrospective chart reviews.

Automates HCC coding, claims validation, and compliance audits.

Supports seamless document retrieval from multiple data sources.

Actuarial Intelligence

Empower your Medicare strategy with competitive data like market share shifts, population risk profiles, utilization patterns, and plan preferences

Get granular insights into member plan selection, utilization patterns and Medicare Advantage adoption across geographies

Manage provider performance leveraging provider analytics and financial forecasting

Benchmark competitive performance across quality, Stars, RAF, and utilization

All powered by the
Data Activation Platform

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

Drive outcomes without the extra cost, or the stress

AI-powered Efficiency

Eliminate tedious, manual workflows with intelligent automation

Accurate Gap Identification

Advanced risk and quality gap analytics ensuring no opportunity is missed.

Maximize Impact

Reduce administrative overhead by minimizing paperwork and inefficiencies.

Seamless Integration

Works effortlessly with your existing systems, supporting bi-directional integration with 200+ EHRs.

Enterprise-grade Security & Compliance

Safe and secure with HIPAA, HITRUST, SoC2 compliance

An integral part of the value-based care suite

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.
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Risk adjustment

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

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

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

Build predictable revenue models, strengthen contract negotiations, and maximize financial performance in value-based care.
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SPOTLIGHT
Empowering health plans to improve member outcomes through value-based pharmacy programs
EmblemHealth, one of the nation's largest nonprofit health insurers, partnered with Innovaccer to launch New York's first pharmacy value-based arrangement focused on improving health outcomes for members with diabetes and hypertension.
INNOVACCER SERVES EMBLEMHEALTH BY:
Building a unified data foundation to power pharmacy quality programs and care management initiatives that connect pharmacies, providers, and care teams in delivering coordinated, whole-person care.
Augmenting and automating pharmacy engagement, quality reporting, and care team workflows to enable timely interventions and close critical care gaps for chronic conditions like diabetes and hypertension.
Why did Emblem Health choose PQS by Innovaccer?
Read the press release

Leading Healthcare Organizations Choose Innovaccer

“Our partnership with Pharmacy Quality Solutions enables us to strengthen relationships with the city’s pharmacies—the cornerstones of community care—while continuing to redefine the scope and reach of healthcare access for members at every touchpoint.”
Abdou Bah
Chief Health Equity Officer of EmblemHealth
“By making data more accessible and accurate, and using AI in practical ways, we can actually solve the day-to-day challenges that providers and payers face.”
Nick Moriello
President of Highmark Blue Cross Blue Shield Delaware
“By making data more accessible and accurate, and using AI in practical ways, we can actually solve the day-to-day challenges that providers and payers face.”
Nick Moriello
President of Highmark Blue Cross Blue Shield Delaware
Resources
News
Effective Payer-Provider Collaboration - An Activation Agent for Improved Health Outcomes
November 21, 2024
Innovaccer surveyed 65 payer organizations to evaluate provider network management expenditure, network size, and organizational challenges, priorities, preferences, and use cases. This report summarizes the survey results and explores how payer organizations navigate the challenges of networ
News
Improving Payer Risk AdjustmentThrough the Power of Data and Provider Connectivity
August 9th, 2024
As the government tightens and scrutinizes risk adjustment practices in the future, health plans must align their practice with accurate member diagnosis and treatment data.

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

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white paper

Five Reasons Why the Modern Payer Needs a Data Activation Platform

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Meet with our payer team.

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