Apixio’s New Prospective Risk Adjustment Solutions Surface Actionable Insights to Improve Risk Capture & Clinical Guidance

Apixio, the AI healthcare analytics company, announced the launch of two advanced prospective solutions, Apicare Insights and Apicare Pre-Visit. These solutions leverage Apixio’s Best in KLAS Risk Adjustment & Analytics technology to deliver a complete and accurate view of the patient and provide clinicians with actionable insights when and where it matters most, at the point-of-care.

In the era of value-based care, healthcare organizations need a prospective risk adjustment program that empowers clinicians at the point of care, meets compliance mandates, and improves patient outcomes. Achieving these goals requires access to complete and accurate patient data. Access to this data is challenging for many reasons, including: Clinical and administrative data is stored in various siloes, and unstructured data is difficult to access and derive insights from in an efficient manner.

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Apixio’s Apicare Insights and Apicare Pre-Visit solutions now allow payers and risk-bearing provider groups to empower clinicians with complete and accurate insights into a patient’s longitudinal medical record. Apixio’s prospective solutions enable healthcare organizations to increase risk capture, improve clinical guidance, and measure value-based care performance by providing high-confidence AI-powered insights.

These prospective solutions leverage AI analytics to identify diagnosis gaps and surface suspected and recaptured conditions. With Apicare Pre-Visit, clinical reviewers have access to patient longitudinal medical records and can surface unconfirmed conditions with evidence-based insights within documents no matter their origin. This AI-assisted workflow allows clinical reviewers to ensure a more complete and accurate patient record. EHR Integration through Apixio’s Infostream is available to providers, enabling them a bi-directional data exchange and the ability to push actionable insights right at the point of care. Apixio’s experience has demonstrated that having AI and clinical reviewers working in tandem results in higher provider acceptance rates, fewer risk gaps, and ultimately, fewer dollars wasted.

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“In most EHRs, the process of reviewing each patient’s medical records requires clinical staff to review a myriad of different tabs and multiple unstructured documents, including dozens of paper records, leading to potentially lost information,” said Apixio’s CEO Sachin Patel. “With these prospective solutions, Apixio does the heavy lifting for you, taking you straight to the insights that matter with the references and information you need to feel confident in the diagnoses and documentation.”

With Apixio’s prospective solutions, organizations can:

• Uncover suspect and known conditions using Apixio’s AI algorithms to improve risk score capture, diagnosis recapture, and documentation;
• Improve operational efficiency by reducing the time and resources spent aggregating and analyzing disparate patient data;
• Track and measure risk gap closures and recognize risk-related revenue earlier in the payment year to improve financial performance.

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