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Improve your ACO's patient risk capture with AI-powered coding & analytics

Protect your Medicare Shared Savings Program (MSSP) benchmark and empower your physicians with AI-powered condition insights that help them accurately document and code patient risk.

HCCIdentifier Coder Workflow - 2020

Supporting accurate, comprehensive risk adjustment for MSSP

As more ACOs move into MSSP tracks with both upside and downside risk, risk adjustment is becoming a critical business activity. To maximize shared savings, your population’s risk must be fully represented on claims. But manually performing retrospective chart reviews, developing patient suspect lists to close gaps, and identifying provider improvement areas is time-consuming, expensive, and often ineffective.

Apixio’s Risk Adjustment Solution for Medicare ACOs uses artificial intelligence (AI) to identify risk-adjusting patient conditions that haven’t been properly documented at the point of care or coded on claims, improving your ACO’s risk capture for Medicare patients.

How we help

Our solution provides reliable analytics and flexible workflow tools to support three important risk adjustment activities for your ACO:
Patient Outreach
Our condition-specific analytics support patient engagement initiatives to drive annual wellness visits (AWVs) or targeted appointments to close care gaps.
Provider Education
Our physician-level analytics support education initiatives for physicians who underperform on risk coding & documentation activities.
Reopening Claims
Our AI-powered coding service identifies supported supplemental ICD codes your team can use to correct claims via clerical error reopenings with your MAC.
Medicare Shared Savings Program Risk Adjustment Technology

Benefits for ACOs

Risk adjustment expertise across government programs

Apixio is the market-leading technology solution for Medicare Advantage (MA) risk adjustment coding. Using HCC Identifier, at-risk provider groups performing retrospective chart reviews for MA have reduced coding time by 80%, increased coding accuracy by 20%, and improved productivity by 4 – 6X. If your ACO plans to take on MA or other value-based contracts in the future, our solution will provide a strong foundation that can evolve with your risk adjustment program.

Proven, scalable technology and results

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large provider and health plan clients nationwide
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years of experience delivering risk adjustment solutions
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million patient charts processed through our platform
Explore how Apixio can support your ACO’s risk adjustment program