Powering Payers with intelligence to improve outcomes & cost
Innovaccer helps payers transform fragmented data into actionable intelligence—reducing costs, improving outcomes, and accelerating compliance in an increasingly complex healthcare landscape.
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Smarter, faster decisions powered by unified data, AI-driven insights, and payer-first design

Innovaccer unifies payer data into actionable intelligence, improving accuracy, accelerating performance, and ensuring compliance across payer programs.
Maximize financial
performance
Leverage unified analytics and AI to reduce medical loss ratios, optimize reimbursements, and proactively manage risk.
Drive operational
efficiency
Simplify workflows, eliminate data silos, and enable faster, more accurate decision-making across teams and departments.
Stay ahead of regulatory demands
Ensure ongoing compliance with HEDIS, CMS, and NCQA guidelines while streamlining audits and reporting with built-in regulatory intelligence.
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Ensure ongoing compliance with HEDIS, CMS, and NCQA guidelines while streamlining audits and reporting with built-in regulatory intelligence.
Risk Adjustment
Capture risk accurately and reduce manual effort.
Close HCC gaps and reduce audit risk with an AI-driven risk adjustment
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Risk Analytics and Dashboards
Chart Retrieval and Coding
Prospective, Concurrent Review, and Retrospective Reviews
Multipoint Gap Closure through point of care, member outreach, pharmacy, and homes
Quality Management
Close more care gaps and improve Star ratings
Enhance Star ratings by closing care gaps faster with AI-powered quality management
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Quality Analytics and Dashboards
Chart Retrieval and Abstraction
Prospective Review, Concurrent Review, and Retrospective Reviews
Multipoint Gap Closure through point of care, member outreach, pharmacy, and homes

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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Experience a unified AI platform empowering payers to drive accuracy, efficiency, and measurable outcomes.

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