Proactive Quality Analytics for Health Plans
Close Gaps, Boost Ratings and Improve Lives
Track quality metrics, close care gaps faster, and improve Star & HEDIS performance all with one intelligent platform built for proactive quality management.
Comprehensive Quality Analytics and
Gap Closure for Payers
End-to-end integrated workflows across office, pharmacy, and home
Real-Time Quality Analytics for Better Ratings & Outcomes
Unlock the full value of your data with AI-driven risk adjustment that powers accurate coding, seamless gap closure, and improved RAF and quality performance.
Real-time performance tracking - HEDIS and Star measures to drive timely, data-informed interventions.
Streamline chart chasing, abstraction, and submissions boosting gap closure rates
NCQA-certified quality workflows to improve rating and compliance
Prospective & Concurrent Reviews
Track quality metrics, close care gaps faster, and improve Star & HEDIS performance—all with one intelligent platform built for proactive quality management.
Surface quality gaps before the patient visit to enable timely intervention
Close gaps with Pharmacy Copilot to drive medication adherence and at-home test kits to streamline closure of care gaps beyond the clinical setting
Provider Copilot delivers in-workflow insights to support accurate documentation and coding
Retro+ Reviews
Innovaccer’s Cost of Care empowers payers to identify cost drivers, improve care quality, and optimize value-based care performance on a unified data and analytics platform.
Identify and capture previously unsubmitted or undocumented diagnosis codes to improve RAF scores
Detect missed coding and documentation gaps across historical clinical and claims data
Leverage bi-directional claims and chart reviews for comprehensive and accurate risk adjustment
Chart Abstraction & Retrieval Platform
Empower payers to design, manage, and optimize value-based care (VBC) programs with precision. From identifying cost drivers and savings opportunities to benchmarking against the market, our solution combines rich analytics, predictive models, and actuarial expertise to help health plans make smarter, faster, and more strategic decisions.
HCC coding to optimize RAF
Charts to be retrieved and allowed for quality & HEDIS abstraction
Faster gap closure through timely access to clinical documentation
All powered by the Data Activation Platform
Labs
Pharmacy
Claims
EMRs
SdoH
Consumer & Digital Health
Third-party Data
Integrate
Raw data is received from source systems & stored in a data lake.
3X more accurate than off-the-shelf AI
Harmonize
Data is parsed & codified, then stored in a simple data structure.
3X more accurate than off-the-shelf AI
Unify
Patient & provider information are aggregated into a single record.
3X more accurate than off-the-shelf AI
Process
Intelligent algorithms enrich the data with quality measures, gaps in care, & more.
3X more accurate than off-the-shelf AI
Analyze
Data is denormalized into a structure for analytics & AI.
3X more accurate than off-the-shelf AI
Drive outcomes without the extra cost, or the stress
AI-powered Efficiency
Eliminate tedious, manual workflows with intelligent automation
Accurate Gap Identification
Advanced risk and quality gap analytics ensuring no opportunity is missed.
Maximize Impact
Reduce administrative overhead by minimizing paperwork and inefficiencies.
Seamless Integration
Works effortlessly with your existing systems, supporting bi-directional integration with 200+ EHRs.
Enterprise-grade Security & Compliance
Safe and secure with HIPAA, HITRUST, SoC2 compliance
An integral part of the value-based care suite
Population Health Analytics
Population Health Analytics leverages the full power of the Data Activation Platform to deliver actionable insights that drive performance in value-based care.
Risk adjustment
Transform your risk adjustment program with intelligent workflows and real-time insights that improve coding accuracy and patient outcomes.
Quality management
Align payers, providers, pharmacies, and members to drive measurable improvements in quality performance.
Care Management
Innovaccer's Care Management Copilot uses advanced AI to automate documentation, generate care insights, and predict patient risk.
Actuarial Intelligence
Build predictable revenue models, strengthen contract negotiations, and maximize financial performance in value-based care.
SPOTLIGHT
Empowering health plans to improve member outcomes through value-based pharmacy programs
EmblemHealth, one of the nation's largest nonprofit health insurers, partnered with Innovaccer to launch New York's first pharmacy value-based arrangement focused on improving health outcomes for members with diabetes and hypertension.
INNOVACCER SERVES EMBLEMHEALTH BY:
Building a unified data foundation to power pharmacy quality programs and care management initiatives that connect pharmacies, providers, and care teams in delivering coordinated, whole-person care.
Augmenting and automating pharmacy engagement, quality reporting, and care team workflows to enable timely interventions and close critical care gaps for chronic conditions like diabetes and hypertension.
Leading Healthcare Organizations Choose Innovaccer
“Our partnership with Pharmacy Quality Solutions enables us to strengthen relationships with the city’s pharmacies—the cornerstones of community care—while continuing to redefine the scope and reach of healthcare access for members at every touchpoint.”
— Abdou Bah, Chief Health Equity Officer of EmblemHealth
“By making data more accessible and accurate, and using AI in practical ways, we can actually solve the day-to-day challenges that providers and payers face.”
— Nick Moriello, President of Highmark Blue Cross Blue Shield Delaware