Apixio leverages artificial intelligence to help healthcare organizations minimize risk.
As value-based care begins to spread through the healthcare system, artificial intelligence (AI) is becoming an important tool to manage risk and boost provider efficiency.
Apixio is at the forefront of these efforts. The California-based data science company has signed up around three dozen health plans and providers for its HCC Auditor tool, an AI-powered risk adjustment platform.
>> READ: People to Insurers: Don’t Use Big Data to Measure Risk
Right now, the company is focused on clients who offer Medicare Advantage products, an area that has garnered close scrutiny from regulators.
“The growth of value-based care is driving the need for deeper healthcare insights, for key activities such as risk adjustment, quality reporting, care and utilization management,” Apixio CEO Darren Schulte, M.D., told Healthcare Analytics News™.
The company’s pitch looks something like this: The Centers for Medicare & Medicaid Services is increasing audits of health plans offering Medicaid Advantage (MA), to ensure correct payments. That means health plans have to keep careful tabs on coding and payments. But unless the…
