• Skip to main content
  • Skip to secondary menu
  • Skip to primary sidebar
  • Skip to secondary sidebar
  • Skip to footer

  • Opinion
  • Health IT
    • Behavioral Health
    • Care Coordination
    • EMR/EHR
    • Interoperability
    • Patient Engagement
    • Population Health Management
    • Revenue Cycle Management
    • Social Determinants of Health
  • Digital Health
    • AI
    • Blockchain
    • Precision Medicine
    • Telehealth
    • Wearables
  • Startups
  • M&A
  • Value-based Care
    • Accountable Care (ACOs)
    • Medicare Advantage
  • Life Sciences
  • Research

Health Fidelity Unveils Risk Analytics to Leverage Big Data to Predict Future Claims

by HITC Staff 03/15/2016 Leave a Comment

  • LinkedIn
  • Twitter
  • Facebook
  • Email
  • Print

Health Fidelity

Today, UPMC-funded startup Health Fidelity announced the launch of Risk Analytics, a new solution that helps healthcare organizations further improve their risk adjustment performance by optimizing ROI, identifying care gaps, and providing a network-wide view of risk adjustment performance.  Now available as a subscription, the new capability enables insurers to better predict prospective claims to help stabilize risk adjustment. 

As a complement to the company’s existing HCC Scout solution, Risk Analytics identifies prospective risk adjustment opportunities in the form of suspected conditions that are not billed to governing entities. By applying proprietary Natural Language Processing (NLP) and big data analytics to unstructured data in clinical charts, Risk Analytics uncovers opportunities that other solutions miss due to incompleteness or inaccuracy in claims data. Risk Analytics can be used independently of, or in concert with, Health Fidelity’s retrospective risk adjustment solution, HCC Scout, to optimize an organization’s overall risk adjustment efforts.

“Despite keen awareness of the problem, most healthcare organizations still struggle with revenue leakage,” said Steve Whitehurst, Chief Executive Officer of Health Fidelity. “Research shows that 40% to 60% of chronic risk conditions are not being captured by plans across the industry. By combining Risk Analytics with HCC Scout, users can benefit from the most complete range of tools to identify, assess, and quantify the risk of patient populations.”

Using innovative technologies, Health Fidelity’s Risk Analytics is able to deliver more actionable information. It allows organizations to make better decisions about where to invest resources for capturing additional risk; it also provides insights for designing risk capture strategies. In addition to these capabilities, Risk Analytics offers easy-to-use dashboards for tracking the progress of prospective risk capture over time. It offers visualizations of program efforts, along with a number of reporting options to summarize performance.

In any healthcare organization, the most useful sources of risk adjustment data are locked away in clinical documents such as progress notes, lab/rad/path reports, admission/discharge papers, and other text-based documentation. Health Fidelity’s NLP technology is able to process content and extract meaning from freeform text, making it possible to include these unstructured data sources in risk adjustment analysis. As a result, Health Fidelity is able to provide the most complete analysis of health plan members.

  • LinkedIn
  • Twitter
  • Facebook
  • Email
  • Print

Tap Native

Get in-depth healthcare technology analysis and commentary delivered straight to your email weekly

Reader Interactions

Primary Sidebar

Subscribe to HIT Consultant

Latest insightful articles delivered straight to your inbox weekly.

Submit a Tip or Pitch

Featured Insights

2025 EMR Software Pricing Guide

2025 EMR Software Pricing Guide

Featured Interview

Paradigm Shift in Diabetes Care with Studio Clinics: Q&A with Reach7 Founder Chun Yong

Most-Read

Medtronic to Separate Diabetes Business into New Standalone Company

Medtronic to Separate Diabetes Business into New Standalone Company

White House, IBM Partner to Fight COVID-19 Using Supercomputers

HHS Sets Pricing Targets for Trump’s EO on Most-Favored-Nation Drug Pricing

23andMe to Mine Genetic Data for Drug Discovery

Regeneron to Acquire Key 23andMe Assets for $256M, Pledges Continuity of Consumer Genome Services

CureIS Healthcare Sues Epic: Alleges Anti-Competitive Practices & Trade Secret Theft

The Evolving Role of Physician Advisors: Bridging the Gap Between Clinicians and Administrators

The Evolving Physician Advisor: From UM to Value-Based Care & AI

UnitedHealth Group Names Stephen Hemsley CEO as Andrew Witty Steps Down

UnitedHealth CEO Andrew Witty Steps Down, Stephen Hemsley Returns as CEO

Omada Health Files for IPO

Omada Health Files for IPO

Blue Cross Blue Shield of Massachusetts Launches "CloseKnit" Virtual-First Primary Care Option

Blue Cross Blue Shield of Massachusetts Launches “CloseKnit” Virtual-First Primary Care Option

Osteoboost Launches First FDA-Cleared Prescription Wearable Nationwide to Combat Low Bone Density

Osteoboost Launches First FDA-Cleared Prescription Wearable Nationwide to Combat Low Bone Density

2019 MedTech Breakthrough Award Category Winners Announced

MedTech Breakthrough Announces 2025 MedTech Breakthrough Award Winners

Secondary Sidebar

Footer

Company

  • About Us
  • Advertise with Us
  • Reprints and Permissions
  • Submit An Op-Ed
  • Contact
  • Subscribe

Editorial Coverage

  • Opinion
  • Health IT
    • Care Coordination
    • EMR/EHR
    • Interoperability
    • Population Health Management
    • Revenue Cycle Management
  • Digital Health
    • Artificial Intelligence
    • Blockchain Tech
    • Precision Medicine
    • Telehealth
    • Wearables
  • Startups
  • Value-Based Care
    • Accountable Care
    • Medicare Advantage

Connect

Subscribe to HIT Consultant Media

Latest insightful articles delivered straight to your inbox weekly

Copyright © 2025. HIT Consultant Media. All Rights Reserved. Privacy Policy |