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Change Healthcare, Health Fidelity Collaborate to Offer NLP-Driven Risk Adjustment Solution

Change Healthcare today announced that it is collaborating with Health Fidelity to offer a risk adjustment solution that embeds natural language processing (NLP) and machine learning technology into its risk adjustment coding offering to help Medicare Advantage, ACA commercial, and Medicaid payers increase claim accuracy and better address compliance obligations.

“Risk adjustment requires a high level of clinical data acquisition and careful analysis of millions of medical records to assign the proper diagnosis code to claims,” said Doug Duskin, senior vice president, and general manager, Clinical Review, Change Healthcare.

108+ population health management companies to know | 2019

To support population health management, 3M offers multiple data tools and services, such as risk adjustment, health risk assessment, medical records coding and auditing, care management analytics, provider profiling, and value-based payment design.

These solutions leverage leading-edge technologies — predictive modeling, natural language processing and data mining — to help payers, providers and government agencies measure and manage healthcare performance.

The company's solutions include medical record retrieval, medical record abstraction, risk adjustment coding, risk adjustment suspecting and targeting, NCQA-certified HEDIS® software, compliance and audit services, and health risk assessments.

Advisory Board provides customized support for care transformation strategy and execution in addition to a consultation team and the Crimson applications technology to help organizations build a transformational population health program.

Altruista's GuidingCare platform is a comprehensive solution that integrates preventative care, acute care, chronic disease management, behavioral health, long-term care and community services into a patient-centered care model that is currently used in 38 states to manage care for 38 million members.

Apixio is a data science company focused on healthcare whose artificial intelligence-driven software solutions enable health plans and providers to pull novel insights from both medical text and codes in order to improve healthcare delivery to their populations.

Apixio's HCC Profiler and Code Compliance Auditor leverage its platform's proprietary algorithms to help coders achieve unprecedented accuracy and efficiency for risk adjustment, and help providers ensure their patients receive the best care possible.

The company's solution is designed to help provider organizations reach financial and quality goals as well as coordinate across the care network and engage patients in personal health and wellness.

Ayasdi's machine intelligence platform combines computing and big data infrastructure with machine learning, statistical geometric algorithms and topical data analysis to help organizations become more productive.

The company's population risk manager aims to predict at-risk patients and populations, and then provide the interventions most likely to help the individual or group succeed at the lowest possible cost.

The platform is powered by a suite of mobile apps that drive better patient decision making, internet-connected devices for remote monitoring, and a host of population health tools to give providers access to patient data in real time.

When using these tools, patients experience increased engagement and satisfaction, while OBGYNs are able to identify patient risk more quickly, improve clinic workflow, and make more money.

The BaseHealth platform can predict the onset of 41 diseases and includes an engine that comprehensively integrates genomic data with behavioral and medical data to provide targeted risk stratification and intervention.

The BioIQ Platform provides tools for orchestrating health testing programs and biometric screening events across multiple healthcare vendors, as well as multi-channel communication tools for engaging participants.

The platform organizes at-home health testing programs and biometric screening events across multiple vendors and provides a means to intervene when risks for chronic care are detected.

The company offers services to support population health, such as analytics, practice transformation support, quality reporting, governance and change management as well as strategic consulting.

The company's population health solutions aim to help transform practice economics so groups can thrive in value-based arrangements with consultative services, data collection and health IT tools.

Their member-driven open health data service assembles a longitudinal view of the patient, ingests each point of contact, and measures performance continuously to inform new interventions.

CareSkore uses diagnosis, clinical, claims and social determinants to profile per-patient needs, generate autonomous care plans and apply AI to offload 30 percent of team tasks, allowing greater patient coverage.

The software is part of Carestream's Clinical Collaboration Platform that provides monitoring and analysis for business and operational planning, system performance, clinical decision support, quality metrics, clinical results, regulatory compliance and peer review.

EHR vendor Cerner's suite of solutions focused on population health is designed to help organizations predict at-risk populations, engage individuals and take action to improve healthcare.

With proven clinical integration expertise to connect disparate EHRs and software applications, Clinigence offers a window to real-time clinical information necessary to close gaps in care and improve population health.

The solution is designed to identify at-risk individuals, manage acute and chronic care, support wellness initiatives, efficiently utilize nursing resources and streamline care coordination with a focus on delivering high quality, cost-effective care.

The company's team has deep expertise in all aspects of strategy, clinical integration, population health management, managed care solutions, financial modeling, care coordination, behavioral health integration, CMS demonstrations, technology assessment and implementation and workforce development.

We are the partner of choice for providers and payers across the United States who are committed to success in the evolving value-based payment environment and developing the diverse talent needed to fill future healthcare roles.

Deloitte's population health management specialists offer knowledge across the healthcare spectrum as well as analytical tools to help healthcare organizations demonstrate population health.

The company's population health solution includes cost utilization dashboards, clinical quality measure dashboards and population health alerts configurable by community or quality thresholds.

eClinicalWorks also provides a care coordination platform that manages secure data exchange between ancillary service providers, health information exchanges, immunization registries and ambulatory EMR.

With more than 1,300 providers, 128 specialty practices and 43 primary care locations, the network aligns independent providers with health systems and their employed provider network to avoid duplicate or unnecessary tests.

Emmi provides multimedia programs and interactive calls to assist with population health management so organizations can conduct scalable, personalized outreach to patients outside of the clinical setting.

Enli Health Intelligence is a population health technology company with a platform that integrates healthcare data with evidence-based guidelines embedded in provider workflows throughout the population as well as at the point of care.

The company aims to promote communication with other EHR and external providers to resolve care gaps as well as promote efforts to create a single plan of care accessible to patients, providers, care managers and other affiliates.

Epic also aims to help healthcare organizations implement and support population health programs with business intelligence scientists and information to assist with cost and resource management.

Experian Health has a suite of solutions to improve the healthcare experience, including patient services, real-time integrated workflow for faster processing and enhanced transparency, as well as built-in data enrichment across the healthcare ecosystem.

The software aggregates measures within a single healthcare provider organization and aims to help improve patient health as well as the healthcare organization's financial health.

Geneia's population health suite can identify and segment at-risk patients, examine variations in care delivery, expand proactive disease management and customize chronic disease care plans across care settings.

Greenway Health's solution can examine data at the enterprise, practice, provider and patient level, working with EHRs as well as practice management systems and health data registries to gather all available information.

The company's proprietary methodology, Behavioral Rx The Science of Population Health, delivers scalable and cost-effective solutions for managing high-risk, chronic and complex wellness issues in partnership with healthcare organizations nationwide.

H3C Enable's platform delivers an enterprise grade call center capability and allows licensed staff to provide annual wellness visit scheduling, chronic care management, transitional care management support and additional non-face-to-face services including scheduling and patient follow up calls.

The company's health analytics dashboard can help organizations drill down to identify provider or patient impact and benchmark an organization's effectiveness against national standards.

HBI Solutions' Spotlight Data Solution includes predicative risk models, dashboards, reports and scorecards that support population health, risk management, readmission management and quality improvement initiatives.

The company also aims to help organizations build relationships and develop care management with tools that can risk stratify members and promote communication among the care team.

Health Dialog provides total population health management services with a health portal, coaching, chronic care management, wellness programs and a 24/7 nurse line.

Health Recovery Solutions supplies home care agencies with an advanced remote monitoring platform focused on changing patient behavior to reduce readmissions and improve clinical outcomes.

Deployed across 60,000 clinical sites by some of the nation's largest payers, HealthBI offers the most widely-used care management and care coordination platform today for population health management.

HealthSignal Partners conducts annual wellness visits, creates best practice-based care plans, provides disease management technology and arranges medical equipment when necessary.

hMetrix is a healthcare business intelligence, data science and operational solutions provider serving payers, employers, heath systems, providers and care management companies.

The PopIQ, a big data platform, is a cloud-based comparative analytics toolset that includes multiple consumers' data sets and can provide cross-population views into population health management.

The company's healthcare data platform, InData, is a scalable, Hadoop-based big data repository that has the capability to ingest data from a variety of sources and perform rapid integration for robust analytics needed to act on population health initiatives.

Built on top of the platform are modules for care management, smart point-of-care alerts and population health and network analytics.In May 2018, Innovaccer raised $25 million Series B funding to build a data platform and drive savings.

In the healthcare field, Informatica provides an enterprise information management system for flexible data management, patient communication and engagement and cloud connectivity for the Salesforce administrator to integrate data with on-premises applications like EMR.

The platform's hub, PopulationHEALTH, is an application that enables organizations to acquire, aggregate, standardize and analyze patient records and define populations across a wide array of clinical identifiers.

iPatientCare is a privately held corporation nationally recognized as one of the leading companies providing EHR and integrated solutions and intelligent medical billing and revenue cycle enhancement services to physician offices providing primary and specialty care, rural health clinics and community/federally qualified health centers nationwide.

Lightbeam Health Solutions offers a patient population and associated risk management platform that sheds light on health data through analytics that will help healthcare providers determine the appropriate care at the right time.

The company offers an end-to-end population health management platform, including applications for patient and physician engagement, care management, referral management, risk stratification and artificial intelligence-powered analytics.

Finally, MedCPU's Advisor compiles data from free text and structured fields within the organization to create a patient database ready for business intelligence, research and real-time processing.

Ariel can identify high-risk patients and help providers use analytics to segment, manage population health data, streamline clinical processes, promote consumer self-management and enable proactive care.

Medical Advantage Group, a subsidiary of The Doctors Company, provides onsite support to optimize clinical functions, customized tools and meaningful market information that can improve population health initiatives and maximize payer incentive opportunities.

Medocity's virtual care platform combines remote monitoring, artificial intelligence, chronic condition management and secure telehealth communications in a single cloud-based ecosystem to enable continous, patient-centered care outside the hospital setting.

Mentrics, ODH's integrated care technology, brings a 360° view of member health by integrating behavioral health, physical health, pharmacy, and social determinants data, and helps achieve better health for high-risk, high-need populations while improving financial performance.

OnPointe's platform has 50,000 lives under contract and the network includes transitional care, long-term care, assisted living, home health, hospice and personal care.

Headquartered in Denver, PeakMedoffers an innovative approach to primary care by creating a platform for doctors and patients to collaborate, coordinate and communicate on personalized care plans that shift reactive medicine to proactive health.

Premier also supports a population health management collaborative to help providers improve patient health status as well as a bundled payment collaborative to assist with episode-based care.

Qlik's healthcare platform provides clinical, financial and operational data through visual analytics that can help reduce costs, improve care and deliver value to patients.

Quantiphi health solutions give healthcare organizations access to more than 300 publicly reported performance measures and pinpoint measures that can drive maximum impact to incentive-linked payments.

Founded in 2003, SAE & Associates is a behavioral health consulting firm providing managed care readiness, population health management services and parity compliance monitoring.

SAE & Associates works with healthcare organizations to implement system solution tools and provides guidance to address behavioral health in a population health management context.

Senscio Systems uses a unique artificially intelligent platform called Ibis to provide continuous intelligent self-management support and timely situational awareness to minimize health deteriorations caused by complex chronic conditions.

Boston-based Massachusetts General Hospital's Laboratory of Computer Science and SGR Technology jointly developed its population health management solution which uses a combination of descriptive and predictive analytics to identify patient needs, engage patients through outreach campaigns and drive better outcomes.

The company's technologies focus on clinical and financial analytics, healthcare survey capabilities, call center solutions and consulting services for physician groups, ACOs, hospitals, health plans and integrated health networks.

Their population health management platform provides a state-of-the-art suite of solutions for data consolidation and visualization, predictive analytics, and financial risk modeling and profiling to empower hospital leaders to manage all aspects of population health.

The company's solutions include e-prescribing, medication history reconciliation, medication management and solutions for GE Centricity customers to engage patients, streamline workflows and optimize patient care.

Transcend Insights®, a wholly owned subsidiary of Humana Inc, empowers population health management with The Platform Above — technology that rises above the data silos and connects care teams with the insights they need to succeed in a value-based care world.

By leveraging its approach to data aggregation, interoperability and analytics, Transcend Insights provides health systems and care teams visibility into population performance to support a more proactive and coordinated approach to care.

The company's approach is modular in nature and easy-to-use, applying artificial intelligence, risk algorithms and quality metrics to stratify and prioritize care interventions for members.

Frost & Sullivan honored VirtualHealth with the 2017 Product Leadership Award in Population Health Management for its cloud-based platform that incorporates clinical care management, secure communications, community service management, connected device integration and provider and member portals.

The company combines predictive analytics technology with software development to help organizations improve their revenue cycle while streamlining workflows, increasing operating efficiency and driving bottom line performance.

The company was originally conceived to help women manage prenatal visits, insurance coverage and costs throughout pregnancy and now includes a smartphone app for pediatric visits to organize the whole family's healthcare needs as well as the Enterprise Platform, population health engagement dashboards that integrate with existing IT systems.

ZeOmega is a value-based care company providing HIE-enabled population health management infrastructure that can help healthcare organizations overcome interoperability issues and achieve the triple aim.

To support population health management, 3M offers multiple data tools and services, such as risk adjustment, health risk assessment, medical records coding and auditing, care management analytics, provider profiling, and value-based payment design.

These solutions leverage leading-edge technologies — predictive modeling, natural language processing and data mining — to help payers, providers and government agencies measure and manage healthcare performance.

The company's solutions include medical record retrieval, medical record abstraction, risk adjustment coding, risk adjustment suspecting and targeting, NCQA-certified HEDIS® software, compliance and audit services, and health risk assessments.

Advisory Board provides customized support for care transformation strategy and execution in addition to a consultation team and the Crimson applications technology to help organizations build a transformational population health program.

Altruista's GuidingCare platform is a comprehensive solution that integrates preventative care, acute care, chronic disease management, behavioral health, long-term care and community services into a patient-centered care model that is currently used in 38 states to manage care for 38 million members.

Apixio is a data science company focused on healthcare whose artificial intelligence-driven software solutions enable health plans and providers to pull novel insights from both medical text and codes in order to improve healthcare delivery to their populations.

Apixio's HCC Profiler and Code Compliance Auditor leverage its platform's proprietary algorithms to help coders achieve unprecedented accuracy and efficiency for risk adjustment, and help providers ensure their patients receive the best care possible.

The company's solution is designed to help provider organizations reach financial and quality goals as well as coordinate across the care network and engage patients in personal health and wellness.

Ayasdi's machine intelligence platform combines computing and big data infrastructure with machine learning, statistical geometric algorithms and topical data analysis to help organizations become more productive.

The company's population risk manager aims to predict at-risk patients and populations, and then provide the interventions most likely to help the individual or group succeed at the lowest possible cost.

The platform is powered by a suite of mobile apps that drive better patient decision making, internet-connected devices for remote monitoring, and a host of population health tools to give providers access to patient data in real time.

When using these tools, patients experience increased engagement and satisfaction, while OBGYNs are able to identify patient risk more quickly, improve clinic workflow, and make more money.

The BaseHealth platform can predict the onset of 41 diseases and includes an engine that comprehensively integrates genomic data with behavioral and medical data to provide targeted risk stratification and intervention.

The BioIQ Platform provides tools for orchestrating health testing programs and biometric screening events across multiple healthcare vendors, as well as multi-channel communication tools for engaging participants.

The platform organizes at-home health testing programs and biometric screening events across multiple vendors and provides a means to intervene when risks for chronic care are detected.

The company offers services to support population health, such as analytics, practice transformation support, quality reporting, governance and change management as well as strategic consulting.

The company's population health solutions aim to help transform practice economics so groups can thrive in value-based arrangements with consultative services, data collection and health IT tools.

Their member-driven open health data service assembles a longitudinal view of the patient, ingests each point of contact, and measures performance continuously to inform new interventions.

CareSkore uses diagnosis, clinical, claims and social determinants to profile per-patient needs, generate autonomous care plans and apply AI to offload 30 percent of team tasks, allowing greater patient coverage.

The software is part of Carestream's Clinical Collaboration Platform that provides monitoring and analysis for business and operational planning, system performance, clinical decision support, quality metrics, clinical results, regulatory compliance and peer review.

EHR vendor Cerner's suite of solutions focused on population health is designed to help organizations predict at-risk populations, engage individuals and take action to improve healthcare.

With proven clinical integration expertise to connect disparate EHRs and software applications, Clinigence offers a window to real-time clinical information necessary to close gaps in care and improve population health.

The solution is designed to identify at-risk individuals, manage acute and chronic care, support wellness initiatives, efficiently utilize nursing resources and streamline care coordination with a focus on delivering high quality, cost-effective care.

The company's team has deep expertise in all aspects of strategy, clinical integration, population health management, managed care solutions, financial modeling, care coordination, behavioral health integration, CMS demonstrations, technology assessment and implementation and workforce development.

We are the partner of choice for providers and payers across the United States who are committed to success in the evolving value-based payment environment and developing the diverse talent needed to fill future healthcare roles.

Deloitte's population health management specialists offer knowledge across the healthcare spectrum as well as analytical tools to help healthcare organizations demonstrate population health.

The company's population health solution includes cost utilization dashboards, clinical quality measure dashboards and population health alerts configurable by community or quality thresholds.

eClinicalWorks also provides a care coordination platform that manages secure data exchange between ancillary service providers, health information exchanges, immunization registries and ambulatory EMR.

With more than 1,300 providers, 128 specialty practices and 43 primary care locations, the network aligns independent providers with health systems and their employed provider network to avoid duplicate or unnecessary tests.

Emmi provides multimedia programs and interactive calls to assist with population health management so organizations can conduct scalable, personalized outreach to patients outside of the clinical setting.

Enli Health Intelligence is a population health technology company with a platform that integrates healthcare data with evidence-based guidelines embedded in provider workflows throughout the population as well as at the point of care.

The company aims to promote communication with other EHR and external providers to resolve care gaps as well as promote efforts to create a single plan of care accessible to patients, providers, care managers and other affiliates.

Epic also aims to help healthcare organizations implement and support population health programs with business intelligence scientists and information to assist with cost and resource management.

Experian Health has a suite of solutions to improve the healthcare experience, including patient services, real-time integrated workflow for faster processing and enhanced transparency, as well as built-in data enrichment across the healthcare ecosystem.

The software aggregates measures within a single healthcare provider organization and aims to help improve patient health as well as the healthcare organization's financial health.

Geneia's population health suite can identify and segment at-risk patients, examine variations in care delivery, expand proactive disease management and customize chronic disease care plans across care settings.

Greenway Health's solution can examine data at the enterprise, practice, provider and patient level, working with EHRs as well as practice management systems and health data registries to gather all available information.

The company's proprietary methodology, Behavioral Rx The Science of Population Health, delivers scalable and cost-effective solutions for managing high-risk, chronic and complex wellness issues in partnership with healthcare organizations nationwide.

H3C Enable's platform delivers an enterprise grade call center capability and allows licensed staff to provide annual wellness visit scheduling, chronic care management, transitional care management support and additional non-face-to-face services including scheduling and patient follow up calls.

The company's health analytics dashboard can help organizations drill down to identify provider or patient impact and benchmark an organization's effectiveness against national standards.

HBI Solutions' Spotlight Data Solution includes predicative risk models, dashboards, reports and scorecards that support population health, risk management, readmission management and quality improvement initiatives.

The company also aims to help organizations build relationships and develop care management with tools that can risk stratify members and promote communication among the care team.

Health Dialog provides total population health management services with a health portal, coaching, chronic care management, wellness programs and a 24/7 nurse line.

Health Recovery Solutions supplies home care agencies with an advanced remote monitoring platform focused on changing patient behavior to reduce readmissions and improve clinical outcomes.

Deployed across 60,000 clinical sites by some of the nation's largest payers, HealthBI offers the most widely-used care management and care coordination platform today for population health management.

HealthSignal Partners conducts annual wellness visits, creates best practice-based care plans, provides disease management technology and arranges medical equipment when necessary.

hMetrix is a healthcare business intelligence, data science and operational solutions provider serving payers, employers, heath systems, providers and care management companies.

The PopIQ, a big data platform, is a cloud-based comparative analytics toolset that includes multiple consumers' data sets and can provide cross-population views into population health management.

The company's healthcare data platform, InData, is a scalable, Hadoop-based big data repository that has the capability to ingest data from a variety of sources and perform rapid integration for robust analytics needed to act on population health initiatives.

Built on top of the platform are modules for care management, smart point-of-care alerts and population health and network analytics.In May 2018, Innovaccer raised $25 million Series B funding to build a data platform and drive savings.

In the healthcare field, Informatica provides an enterprise information management system for flexible data management, patient communication and engagement and cloud connectivity for the Salesforce administrator to integrate data with on-premises applications like EMR.

The platform's hub, PopulationHEALTH, is an application that enables organizations to acquire, aggregate, standardize and analyze patient records and define populations across a wide array of clinical identifiers.

iPatientCare is a privately held corporation nationally recognized as one of the leading companies providing EHR and integrated solutions and intelligent medical billing and revenue cycle enhancement services to physician offices providing primary and specialty care, rural health clinics and community/federally qualified health centers nationwide.

Lightbeam Health Solutions offers a patient population and associated risk management platform that sheds light on health data through analytics that will help healthcare providers determine the appropriate care at the right time.

The company offers an end-to-end population health management platform, including applications for patient and physician engagement, care management, referral management, risk stratification and artificial intelligence-powered analytics.

Finally, MedCPU's Advisor compiles data from free text and structured fields within the organization to create a patient database ready for business intelligence, research and real-time processing.

Ariel can identify high-risk patients and help providers use analytics to segment, manage population health data, streamline clinical processes, promote consumer self-management and enable proactive care.

Medical Advantage Group, a subsidiary of The Doctors Company, provides onsite support to optimize clinical functions, customized tools and meaningful market information that can improve population health initiatives and maximize payer incentive opportunities.

Medocity's virtual care platform combines remote monitoring, artificial intelligence, chronic condition management and secure telehealth communications in a single cloud-based ecosystem to enable continous, patient-centered care outside the hospital setting.

Mentrics, ODH's integrated care technology, brings a 360° view of member health by integrating behavioral health, physical health, pharmacy, and social determinants data, and helps achieve better health for high-risk, high-need populations while improving financial performance.

OnPointe's platform has 50,000 lives under contract and the network includes transitional care, long-term care, assisted living, home health, hospice and personal care.

Headquartered in Denver, PeakMedoffers an innovative approach to primary care by creating a platform for doctors and patients to collaborate, coordinate and communicate on personalized care plans that shift reactive medicine to proactive health.

Premier also supports a population health management collaborative to help providers improve patient health status as well as a bundled payment collaborative to assist with episode-based care.

Quantiphi health solutions give healthcare organizations access to more than 300 publicly reported performance measures and pinpoint measures that can drive maximum impact to incentive-linked payments.

Senscio Systems uses a unique artificially intelligent platform called Ibis to provide continuous intelligent self-management support and timely situational awareness to minimize health deteriorations caused by complex chronic conditions.

Boston-based Massachusetts General Hospital's Laboratory of Computer Science and SGR Technology jointly developed its population health management solution which uses a combination of descriptive and predictive analytics to identify patient needs, engage patients through outreach campaigns and drive better outcomes.

The company's technologies focus on clinical and financial analytics, healthcare survey capabilities, call center solutions and consulting services for physician groups, ACOs, hospitals, health plans and integrated health networks.

Their population health management platform provides a state-of-the-art suite of solutions for data consolidation and visualization, predictive analytics, and financial risk modeling and profiling to empower hospital leaders to manage all aspects of population health.

The company's solutions include e-prescribing, medication history reconciliation, medication management and solutions for GE Centricity customers to engage patients, streamline workflows and optimize patient care.

Transcend Insights®, a wholly owned subsidiary of Humana Inc, empowers population health management with The Platform Above — technology that rises above the data silos and connects care teams with the insights they need to succeed in a value-based care world.

By leveraging its approach to data aggregation, interoperability and analytics, Transcend Insights provides health systems and care teams visibility into population performance to support a more proactive and coordinated approach to care.

Frost & Sullivan honored VirtualHealth with the 2017 Product Leadership Award in Population Health Management for its cloud-based platform that incorporates clinical care management, secure communications, community service management, connected device integration and provider and member portals.

The company combines predictive analytics technology with software development to help organizations improve their revenue cycle while streamlining workflows, increasing operating efficiency and driving bottom line performance.

The company was originally conceived to help women manage prenatal visits, insurance coverage and costs throughout pregnancy and now includes a smartphone app for pediatric visits to organize the whole family's healthcare needs as well as the Enterprise Platform, population health engagement dashboards that integrate with existing IT systems.

Natural Language Processing Market 2015 2019

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Biomedical informatics | Wikipedia audio article

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