Commercial, Medicare, and Medicaid lines of business all face unique challenges in a rapidly changing market. The key to success, however, remains constant: smart decisions based on sound data. Whether you want to improve payment accuracy, risk adjustment, care quality, or network performance, we have the most complete set of solutions to meet your needs, backed by decades of experience and our passionate commitment to your success. 

Provider organizations have moved steadily into value-based healthcare delivery and payment programs. However, successful risk management is as challenging as it is essential. 

Our performance analytics solutions help provider organizations understand and mitigate clinical and financial risks, delivering the insights needed to design and refine high-impact population health strategies. Our track record of success in managing multi-payer claim sets and other clinical data allows accountable care organizations and other risk-bearing providers to create a true longitudinal record across many settings of care to make better, data-driven decisions.

Government agencies, in particular the Centers for Medicare & Medicaid Services (CMS), face unique challenges measuring and managing healthcare quality; optimizing risk adjustment programs; and preventing fraud, waste, and abuse. The United States wastes nearly $1 trillion annually on healthcare spending—an estimated $600 billion of which can be attributed to unnecessary care and other inappropriate payments.