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Actionable Analytics for Risk Adjustment and Revenue Optimization for Health Plans

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Pinpoint the most impactful members

Close coding and quality gaps to improve risk score accuracy and quality ratings

Foster effective working relationships with providers

Maximize program ROI with an informed and transparent measurement process

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Population Advyzer is accelerating our program objectives to deliver higher-quality care at a lower price by using more accurate and transparent analytics.

C-Suite Executive, Large National Health Plan

Pinpoint the most impactful members and optimize results

Take aim with accuracy and pursue the right interventions for the most impactful members to minimize wasteful activities.

  • Gain greater visibility into the data model to uncover why certain members and providers should – and should not – be pursued for outreach
  • Continually measure and evaluate intervention workflow success with in-depth intervention analysis tools
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coding gaps - blue health intelligence

Close coding and quality gaps for Medicare Advantage and ACA populations

Improve risk score accuracy, quality ratings, and more

  • Accurately capture health risks and ensure reimbursement reflects the actual risks within a plan’s ACA and Medicare Advantage populations
  • Leverage risk adjustment best practices gained from successful collaborations with partner plans

Foster effective working relationships with providers

Engage providers to help them improve coding and risk capture, while maintaining positive working relationships

  • View provider results by a variety of organizational dimensions, such as ACOs, health systems, provider groups, and/or individual providers
  • Optimize interventions, like chart reviews, in-home visits, and member outreach efforts, by feeding analytics and action recommendations directly into health plan and provider workflow tools – portals, EMRs and direct data feeds
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Maximize program ROI with an informed and transparent measurement process

Augment existing systems and processes with a collaborative solution that unbundles analytics from interventions

  • Leverage a flexible, fully transparent, and customer-controlled solution that allows you to maintain and support key in-house and outsourced RA functions
  • Set and manage to goals, and provide complete visibility into key program success metrics, reports, and useful insights

CASE STUDY

How BHI’s Population Advyzer Helped Three Health Plans Achieve Significant ROI in Risk Adjustment
Population Advyzer was employed to improve the efficiency of three health plans’ risk adjustment programs while helping them reach or surpass previous years’ results. While each plan faced unique market dynamics, geographic considerations, and provider affiliations, the Population Advyzer playbook was effective in every case.
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The Single Source of Truth

To successfully deliver customized products in a scalable, repeatable, and efficient way, each SaaS solution leverages BHI's our collaborative data platform. Every character in every data file, combined with business and/or clinically driven analytics, modeling, and machine learning flows through BHI’s collaborative platform in the same way. The result – a single source of BHI data and analytical truth.