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Alternative Payment Models

The future of U.S. healthcare is here. Administering these complex payments requires new technology designed specifically for the nuances of value-based care.


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Utilize Any Data Source

Formulating strategies to mitigate clinical and financial risk begins with data-derived insights. At the heart of our value-based care platform is a flexible and scalable data lake. Our dedicated data team helps onboard and refresh applicable data types from hundreds of sources and vendors. The result is a single source of truth with normalized data available to utilize across our integrated platform applications. Centralizing all your value-based data, analytics, care, and payment solutions with one vendor minimizes the chances of errors or duplicate work.

Manage Risk Confidently

Forecast and visualize performance in APMs to understand and communicate the clinical and financial risk factors that will impact your bottom line. Surface insights related to quality, risk, leakage, and MLR, and spot and correct variations in trends. Automate distribution of reports and insights to network providers and stakeholders across the enterprise, bringing transparency to your goals and performance measurements. Prescriptive and predictive analytics expose new potential diagnoses and utilization patterns for your team to manage proactively. With the ability to view social determinants data, care managers can deliver appropriate and equitable care.

Coordinate Person-Centric Care

Helping care teams act on analytic insights is a requirement for any alterative payment model. Our care management tools assign members and patients to care pathways that empower care teams and providers to address treatment opportunities and close priority care gaps. Highlight potential record discrepancies and support evidence-based decision making with integrated clinical guidelines applied to EHR and payer data. Incorporate condition and care gap dashboards in the EHR to surface insights for providers within their traditional workflows.

Administer Complex APMs

Administering and adjudicating bundles and capitation claims is a nuanced process that most leading core administrative processing systems don’t support very well. This puts the burden and risk of creating manual workarounds on clinical and administrative teams. Our payment technologies were designed specifically for APMs, with proprietary technology to manage multiple provider contracts under a single ID, package and price claims, and process payments and reimbursements. With support from our Bundles Division, you can access comprehensive bundled payment services, including program design, management, and claims administration.

See Our Solutions in Action

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Explore the Platform

The right solution for your value-based journey is only a click away. Our modular technology is quickly and easily integrated into current systems and complements existing IT investments so that we can grow with you.

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