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Improve risk adjustment for
your health plan

The Innovaccer Health Cloud helps identify coding gaps based on data-driven analytics to
meet your risk adjustment needs.

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America’s largest healthcare organizations are connecting their care ecosystems on the Innovaccer Health Cloud
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The Innovaccer Health Cloud for
Risk Adjustment
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Identify drop or suspect codes
Analyze historical claims data and clinical documentation to identify
drop codes and suspect codes. Run risk adjustment analytics to
identify diagnosis codes and HCC codes supporting review
outcomes.
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Aggregate claims and clinical data
Integrate data into one cohesive application with turnkey tools that extract, aggregate, and normalize data from various clinical and financial systems.
Run analytics for drop suspect codes review
Enable providers to improve coding accuracy with insights on gaps at the point of care. Improve review outcomes with NLP-facilitated coder chart review workflows.
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Expand from top 10
HCCs to top 60 HCCs
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Identify gaps based on
structural clinical data
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Extract data from non-electronic
data files with OCR/NLP

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Identify coding gaps at the point of care
Identify coding gaps during outpatient visits with an EMR-integrated
interface. Drive point-of-care prospective review gap closure.
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Close Gaps Quickly
Improve care delivery in your provider network by leveraging technology to close HCC coding gaps within data sources.
Measure Provider Performance
Help providers to address gaps with an EMR integration that can push accepted coding changes, track gaps in performance, and create provider scorecards.
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Point-of-care
prospective review
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Bidirectional EMR communications
to address diagnosis codes

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Access clinical data in digital charts
Connect directly with EMR systems for automated access to clinical
data. Bring in structured clinical data and clinical documentation for
downstream risk adjustment needs.
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Extract and Process Clinical Data
Utilize prebuilt connectors to directly integrate with EMR systems; capture relevant, historical clinical data; and view updates on member and provider satisfaction.
Access Chart Review Workflows for
Retrospective Review
Close coding gaps with NLP-facilitated coder chart review workflows.
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Efficient medical
record retrieval
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Retrospective gaps
closure
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Enhanced provider
experience

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Track risk adjustment performance
over time
View highly customized dashboards with insights on outcomes and
operational metrics.
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Business Intelligence
Monitor risk scores and related metrics, such as percentage of members with HCCs, average risk scores, and expected gaps at the member and provider level.
Find Opportunities for Risk Adjustment
Analyze low-performing areas on measures like HCC codes and track operational efficiency metrics.
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Identify high-risk
members
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Close coding
gaps
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Improve risk
adjustment

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USEFUL RESOURCES

What's new in healthcare

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Blog
3 Ways to Provide Better Care in Managed Medicaid Contracts
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Research Paper
How Data Platforms Transform Healthcare for Tomorrow
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Webinar
The Impact of Digital Transformation on the Payer Industry

Activate your vision for a healthier world

Join other healthcare leaders in building the future of
health on the Innovaccer Health Cloud.