Population Advyzer

Advanced analytics for revenue optimization and case identification and stratification for care management, this suite of solutions includes predictive models, workflow management, and operational tools for commercial, Medicare Advantage, large accounts, accountable care organizations, and health plans’ entire book of business.

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Identify the most impactful members and providers and guide interventions with three distinct and flexible modules


Assess risk, improve care, and control costs by determining the right members to engage at the right time.

Improve commercial risk score accuracy and (QRS) quality ratings

Identify and close diagnosis coding gaps, quality gaps, and more.

Achieve impact within budget

Prioritize efforts on the most impactful members for interventions and de-prioritize members already managing costly chronic conditions.

Gain more visibility and control

Achieve better accuracy in targeting and access a comprehensive data model to uncover why certain targets should, and should not be, pursued.

Optimize interventions

Measure and evaluate intervention success with intervention analysis tools.

Coding Gaps chart

Medicare Advantage

Make a direct impact on risk adjustment ROI with underlying methodology aligned for the Medicare Advantage population.

Improve Medicare Advantage risk score accuracy and STAR quality ratings

Identify and close diagnosis coding gaps, quality gaps, and more.

Get better insights for informed outreach

Be informed about opportunities to optimize interventions for cost savings and to better manage vendors.

Gain more visibility and control

Achieve better potential and better quality with greater confidence in results.

Optimize interventions

Measure and evaluate intervention success with intervention analysis tools.

Summary by Condition chart

Care management

Care management is expensive. Targeting the right members is critical. Move beyond resource-based risk identification to predictive analytics and a powerful opportunity score that identifies members with the greatest potential for cost savings and improved health. Segment the members who will be the most impacted by high-touch care management, guide members to more appropriate sites of care, and achieve the best care management results.  

Provide member-centric care

Access a 360 view of member care with greater insights on risk including scores on health status, disability, and mortality. Identify members with declining health and members at risk for admissions and re-admissions. Focus on closing the gaps in care that matter most.

Precisely target members who will be impacted the most

Focus care management efforts on opportunities that drive measureable cost savings for all populations; large accounts, Medicare Advantage, commercial, and ASO.

Improve collaboration and care coordination

Foster good communication between the plan, members, and providers with a solution that takes complex data, organizes it, and outputs reports and insights to share.

Prove ROI and impact

Use Program Performance Tracking to measure and report on special care management programs.

Patient KPI chart

Break down silos and realize the benefits of a truly member-centric approach on an integrated platform

Jane, health plan member


Health Plan Member

Population Advyzer works in favor of health plan member Jane, the health plan, and the provider.

Win-win-win for members, health plans, and providers

Jane receives better healthcare and guidance.

Jane is now managing her diabetes and taking preventative measures, including a regular eye exam, HbA1c testing, and healthy choices to keep her insulin levels in check.

Health plan increases quality ratings and revenue.

The health plan received a more accurate and increased risk-adjusted payment for Jane through government programs like commercial and Medicare Advantage that reimburse based on quality measures, including specific programs aimed at improving member health. With Population Advyzer’s member-centric approach, the health plan maximized provider collaboration, achieved coordinated member activities, and optimized interventions.

Provider receives incentive for engaging in value-based networks.

Provider receives a quality score based on performance and gets paid accordingly by the value-based health plan. So, everybody wins!

Focus in on opportunities and take action with Population Advyzer.

Who do we need to intervene with?

These advanced targeting analytic tools help health plans uncover optimal members for intervention outreach and show how to set the correct directional focus moving forward.

Executive Overview

Pursuit lists

Health plans can set their own parameters to identify their highest impact members. Set by:

  • Budget
  • Provider network
  • How they want to engage members

How should we intervene?

Executive Overview

Patient-centered reports

Health plans are empowered with the insights needed to engage the provider and encourage them to have the patient assessed for suspected conditions.

Are my intervention programs working?

Executive Overview

Intervention measurement tools

Measure which interventions are performing best so you can optimize and set the right directional focus for programs moving forward.

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