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CareAnalytixAI-Powered Analytics for Risk-Bearing Healthcare
One platform to manage at-risk and non-risk contracts, close care gaps, capture accurate risk adjustment and control costs for MSOs, IPAs and Medicare Advantage groups.
Trusted for over a decade by diverse healthcare organizations.
Lots of data. Little time. Even less margin.
Risk-bearing organizations hold vast amounts of claims, eligibility, encounter, pharmacy and lab data, but rarely in one trustworthy place. Risk-model changes, audit scrutiny and Star-rating pressure leave little room for missed diagnoses, open care gaps or runaway specialist costs.
The SolutionCareAnalytix unifies your CMS, health plan, EHR and claims data, then uses AI to surface what needs attention first: which patients, which providers, which dollars.
Intelligence that tells you where to act first
Predictive risk stratification
Identify patients likely to become high-cost, be admitted or readmitted so care teams act earlier.
HCC & risk adjustment intelligence
Flag suspected, uncoded and recapture-due conditions under the current CMS-HCC model, with evidence for clinician review.
Care-gap prioritization
Rank open HEDIS and Star measures by impact and closability, by provider and by patient.
Ask CareAnalytix
Ask questions in plain English and get answers with charts, with no report-building required.
Anomaly detection
Catch unusual utilization, cost spikes and billing patterns before they become problems.
AI-generated summaries
Monthly executive and provider scorecards written automatically, ready to share.
Document intelligence
Extract diagnoses and key data from faxed records, PDFs and scanned charts.
See it with your data
Book a walkthrough using a de-identified sample of your own population.
Request a demoEverything an MSO or IPA needs, in one place
Contract & network management
- MSO & IPA administration portal
- At-risk and non-risk contract monitoring
- Beneficiary & member management (MPI)
- Authorizations & eligibility management
Clinical & quality
- Population health reporting & risk assessment
- HEDIS, MRA and MLR reporting
- Case & care management
- Risk assessment alerts
Financial
- Revenue & payment management
- Claims adjudication
- Costs by CPT, physician, patient or period
- High-cost, Rx and specialist spend reporting
Connectivity
- Provider & patient portals
- CMS data exchange & HIPAA 5010 EDI
- HL7, FHIR & web-service integration with EHRs, labs and hospitals
- Secure messaging & feedback management
Built for organizations that carry risk
ACO analytics capabilities are now part of CareAnalytix.
Security & deployment
Hosted on Microsoft Azure with a HIPAA compliant DMZ and HIPAA-compliant operations. BAAs available on request. Available as SaaS or in a dedicated environment.