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Take control of your risk adjustment analytics

Learn how artificial intelligence can increase revenue accuracy by 20+%
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Solution overview

Population Advyzer is the most efficient, accurate, and flexible risk adjustment business intelligence platform available


Medicare Advantage (MA) and ACA commercial risk adjustment programs must continually find new ways to capture population risk. The challenge is identifying the right members for gap closure activities. The solution is analytics that maximize coding efforts while helping you remain compliant.

Population Advyzer reaches beyond “trigger events” and rules-based algorithms. Built on the nation’s largest commercial claims database and an advanced machine learning engine, we leverage artificial intelligence to process 2,000+ predictors from multiple data sources to uncover hidden population risk.

For one health plan, our machine learning and advanced algorithms targeted 45% fewer members with care gaps yet the resulting analytics captured 80% of understated revenue.


Analytic tools for transparent and detailed data

Discover how our risk adjustment analytics unlock actionable information from your healthcare data.

Customer experience
“Unlike other solutions, BHI’s fully transparent information helps plans decide which actions to take and which actions not to take – resulting in reimbursement that better reflects the actual health status of their populations.”
CHIEF MEDICAL OFFICER, HEALTHCARE START-UP

CLIENT SUCCESS STORY

How 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, Population Advyzer was effective in every case.
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Population Advyzer advantages

    • A complete analytics program
      Integrates essential methodologies into a transparent, multidimensional data model
    • Advanced gap identification models
      Captures hard-to-detect understated risk using advanced analytics and machine learning models
    • Provider-centric insights
      Flags providers who may be candidates for outreach and education
    • Intervention-targeting intelligence
      Informs the right audience at the right time about when to and when not to intervene
    • Flexible integration
      Integrates into any environment. Results files support actuarial needs, medical record
      reviews, in-home assessments, and prospective provider engagement efforts
    • Transparent, collaborative partnership
      Supports your internal team in growing analytics capabilities by transparently sharing and adapting algorithms and measuring progress

Using specialized analytics vs. end-to-end solutions

End-to-end solution providers have an incentive to maximize costly gap closure activities. Because we unbundle analytics from interventions, we never recommend chart chases that yield a poor return on investment. At a time when operational efficiency is critical, BHI’s analytics-only approach can save health plans millions of dollars a year.

Our only goal is to help you get better control of your risk adjustment program to improve outcomes.

By leveraging our analytics, clients have seen a 12:1 return on their medical record review efforts and a 6:1 return on their overall programs.

VIEW THE LATEST WEBINAR

Unmasking Unidentified Risk in a Blue Plan Population Using Population Advyzer’s Risk Adjustment Analytics and AI

Highlights:

  • Why Arkansas Blue Cross Blue Shield sought greater internal control of its analytics
  • How transparency, collaboration, and measure-to-improve are central to best-in-class risk adjustment analytics
  • The results of a comparative retrospective study comparing BHI's machine learning analytics vs. an existing vendor in terms of gaps targeted, closure rates, and captured and uncaptured revenue accuracy
  • How combining machine learning with traditional algorithms increased one health plan's revenue accuracy by more than 20%

Contact us today to experience our industry-leading risk adjustment analytics.

Request a demo
Solution overview