Alternatives to CareJourney
Compare CareJourney alternatives for your business or organization using the curated list below. SourceForge ranks the best alternatives to CareJourney in 2026. Compare features, ratings, user reviews, pricing, and more from CareJourney competitors and alternatives in order to make an informed decision for your business.
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Pearl
Pearl
Pearl’s AI-powered platform helps care teams reduce avoidable costs, improve outcomes, and succeed in value-based care by identifying high-priority patients, prompting timely action, and fitting into existing workflows, without adding noise. Their technology unites predictive intelligence with operational execution; it prioritizes high-impact outreach and automates next steps, assesses provider readiness and cohort-risk to match participants to the right payment models, connects intelligence with action to deliver measurable improvements in clinical, financial, and operational performance, and integrates seamlessly into provider systems so teams can deliver high-quality care at scale. Its data-science and actuarial engine optimizes savings, enhances benchmarks, supports ACO REACH, MSSP, and Medicare Advantage models, and engages physicians with tools that simplify care delivery, free them from routine tasks, and support better patient-panel management. -
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Battelle
Battelle
We provide insights that help healthcare systems better serve their patients. That’s why providers such as the Centers for Medicare & Medicaid Services (CMS) and the Defense Health Agency (DHA) choose Battelle to drive innovation and optimization. Battelle improves the performance of health systems, small and large. Our goal is to improve the performance of the healthcare system by solving the challenges needed to keep pace with the need for better information to guide clinical decision-making at the point of care. Our solutions improve patient outcomes and reduce unwarranted variation in healthcare delivery. We evaluate how different types of messages across communication channels perform and examine the effectiveness of proposed messages and materials. -
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Trella Health Marketscape
Trella Health
There are patients who desperately need your home health services — yet many physicians who could be referring them aren’t. That’s likely because your sales and marketing teams aren’t seeing the 75% of Medicare claims associated with office visits. Demonstrate your ability to lower costs and improve patient outcomes. Home Health Agency A can quickly demonstrate how it outperforms Home Health Agency B on hospitalization and readmission rates. Marketscape for Home Health helps you redefine your sales and marketing strategy to ensure you’re focusing on high-potential physician and facility referral sources. Our breakthrough technology and support help you: Quickly evaluate how you compare to your peers by hospital and readmission rates, diagnostic category, acuity level, time to start of care, total cost of care, and many other quality metrics. -
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CareEmpower
HealthBI
Plans and providers are under pressure to deliver higher quality and more cost-effective whole health care for the most vulnerable and complex members. Let us help. We can help solve burdensome processes, fragment care teams and disparate data silos that get in the way of delivering integrated whole-person care while managing new value-based requirements and solving for behavioral health and social factors. Our country spends $33 billion dollars annually on avoidable hospital admissions as a result of poor care coordination and care transitions management, an effective solution is overdue. CareEmpower is a feature-rich solution like no other care navigation system you have used. Whether your organization’s goal is to quickly accelerate your medicare advantage program or to deploy a robust population health program for any of your at-risk populations, CareEmpower has what you need. Stratification and prioritization of all care opportunities for at-risk populations. -
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Care Director
Altera Digital Health
Achieving the care coordination goals at lower cost is critical in ensuring patient satisfaction and loyalty. But these goals are complex. Your organization needs population health software that provides a shareable care plan that extends across all healthcare settings—without forcing users to leave their workflow. You need to be able to reach out to patients with automated tools, freeing up your care coordinators for more strategic tasks. It’s time for Care Director. With Care Director, your team can more efficiently coordinate outpatient care, stratify patients into at-risk and healthy populations and receive care recommendations based on actionable, clinical intelligence, resulting in more timely interventions and improved population health. Care Director enables providers to access a holistic care plan within their native workflows, so they can get information and communicate back to care navigators with minimal clicks. -
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Phamily
Jaan Health
Reverse declining reimbursements with new monthly. Chronic Care Management revenue. Phamily makes CCM simple, scalable, and 5-10x more profitable. Chronic Care Management (CCM) is a new program from The Centers for Medicare & Medicaid Services (CMS) that: offers monthly reimbursement for the support you regularly provide patients between visits. Allows billing for everyday activities done by your staff, e.g. phone calls, refills, referrals, labs. Incentivizes a higher standard of care for patients with multiple chronic conditions. Offers an additional $42-$139+ per patient per month based on time and complexity. Chronic Care Management could be a lifeline. But without the proper tools, it’s a dead end. A typical provider can enroll 250 CCM patients and earn $125,000+ per year. However, most organizations actually lose money on CCM because they try a brute force labor-intensive approach using EHRs, monthly phone calls, and manual documentation. -
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Health Dialog
Health Dialog
Whether seeking treatment for a common cold or a chronic condition like diabetes or heart disease, when people are sick or have a family member facing illness, they often have questions, concerns, or could use guidance to ensure they understand and are able to adhere to their treatment. Health Dialog offers a suite of personalized population health solutions that address these issues and empower your members to improve their whole-being health, while reducing overall costs. Our healthcare experts provide one-on-one health coaching through personalized outreach to help identified members better manage their chronic conditions, such as asthma, diabetes and heart disease. We identify members at-risk for nonadherence, determine the best method for engaging them, and educate them to encourage ongoing medication-taking behavior. Give your members 24/7 access to a live registered nurse who can provide clinical advice, refer services, impart skills and provide relevant educational materials. -
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HEALTHsuite
RAM Technologies
HEALTHsuite is a comprehensive benefit administration system and claims processing software solution designed for health plans administering Medicaid and / or Medicare Advantage benefits. HEALTHsuite is a rules-based auto adjudication software solution designed to automate all aspects of enrollment / eligibility, benefit administration, provider contracting / reimbursement, premium billing, medical management, care management, claims adjudication, customer service, reporting and more. RAM’s Medicare Advantage-in-a-Box offering is unique in the industry; the product of RAM’s extensive experience in Medicare Advantage and an unwavering commitment to changing our industry. HEALTHsuite Advantage™ and eHealthsuite™ are the cornerstones of our pre-configured Medicare Advantage-in-a-Box offering. HEALTHsuite Advantage is a fully integrated suite of modules providing our clients with an unmatched solution to administer their Medicare Advantage and Special Needs Plans (SNP’s). -
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AWS HealthLake
Amazon
Extract meaning from unstructured data with integrated Amazon Comprehend Medical for easy search and querying. Make predictions on health data using Amazon Athena queries, Amazon SageMaker ML models, and Amazon QuickSight analytics. Support interoperable standards such as the Fast Healthcare Interoperability Resources (FHIR). Run medical imaging applications in the cloud to increase scale and reduce costs. AWS HealthLake is a HIPAA-eligible service offering healthcare and life sciences companies a chronological view of individual or patient population health data for query and analytics at scale. Analyze population health trends, predict outcomes, and manage costs with advanced analytics tools and ML models. Identify opportunities to close gaps in care and deliver targeted interventions with a longitudinal view of patient journeys. Apply advanced analytics and ML to newly structured data to optimize appointment scheduling and reduce unnecessary procedures. -
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HealthAPIx
Google
Make it easy for healthcare organizations, including hospitals and clinics, health plans and life sciences, to connect with app developers and health data partners to build new FHIR API-based digital services. Improve the efficiency and safety of transitions across the continuum of in-patient and out-patient care. Provide targeted personal wellness and prevention guidance to at-risk participants. Empower collaboration between patients, physicians, and healthcare providers to effectively manage chronic conditions. Improve chronic condition management. Deliver patient-centric digital services. Reduce risks during care transitions. Manage, secure, and scale APIs with an enterprise-grade platform that is FHIR-server agnostic. Easily ingest healthcare data from internal, external, or open-source FHIR-ready partners. Deliver on the promise of patient-centric healthcare and data interoperability by quickly launching digital services like new mobile apps. -
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Virtual Benefits Administrator (VBA)
Virtual Benefits Administrator
Virtual Benefits Administrator (VBA) is the industry's leading cloud-based benefits administration software solution. With a robust functionality and unlimited flexibility, VBA allows users to build and manage medical, vision, dental, disability, Medicaid, Medicare, Medicare Supplement, care management, long-term care health benefits, health savings accounts (HSAs), flexible spending accounts (FSAs), health reimbursement accounts (HRAs), and COBRA. -
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Leverage analytic insight to reduce variation, improve care quality, optimize care coordination and manage financial performance. Whether you’re operating in a fee-for-service or risk-based environment, you can use the unsurpassed data and analytics capabilities and expert guidance of Optum® Performance Analytics to position your organization for success in an ever-evolving health care landscape. Optum Performance Analytics offers enriched clinical and financial longitudinal views of your patients, physicians, facilities and networks. Integrating your diverse clinical and claims data with a growing set of sociodemographic, behavioral and patient-reported data adds greater context and insight. Optum Performance Analytics is built with the flexibility to meet the goals of any health care system. Organizations seeking specific direction can leverage pre-built dashboards and opportunity reports to surface opportunities for enhancing care or reducing costs.
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Oracle Health Care Tracker
Oracle Health
Long term care solution that helps organizations manage patient records, track goals, thresholds or trends and more. Oracle Health Care Tracker is a quick-to-deploy and easy-to-use electronic data collection solution that helps eliminate the need for paper documentation. Track individuals at risk for COVID-19. As entities seek to provide care to at-risk populations in a number of different configurations and care sites, they need a tool that can be stood up quickly and can accommodate their needs for data capture and tracking of patient information. Care Tracker helps monitor individuals quickly and accurately. Care Tracker is a quick-to-deploy and easy-to-use electronic data collection solution that helps eliminate the need for paper documentation. The solution supports your documentation needs at a variety of care sites — post-acute care venues, hotels, convention centers and more — with assessments focused on social determinants of health. -
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Axxess Home Health
Axxess
Increase your organization’s cash flow by processing claims from Medicare, Medicaid and all other commercial payers. Automated processing of all payer claims in real time from anywhere at anytime ensures your claims get processed and get paid faster. Automatically submit and track your claims from anywhere at any time with real-time claims status updates. You are assigned a dedicated account manager that is a certified health care claims manager. You even have their mobile phone number. Diversify your revenue sources and improve your cash flow with our automated, anytime, anywhere claims processing with complete visibility to all your electronic funds transfers (EFT) and payment projections. Process, track and fix claims in real-time to capture all your revenue while eliminating costly time-consuming processes. Automate Medicare eligibility verification and claims processing. -
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Direct Care Innovations
Direct Care Innovations
DCI focuses on providers and Government Agencies in the Medicaid, Medicare, and Managed Care Markets. Our software solutions streamline processes, allowing you to serve the direct care industry with coverage in all locations - from cities to rural areas. Our team can have you live in under 90 days. Are you looking to improve authorization management of your healthcare agency? At Direct Care Innovations (DCI), we offer our Real-Time Authorization Management Module as part of our business management platform. We designed the authorization module to serve as a real-time data management and reconciliation system for Medicaid, Medicare, Managed Care, and other service code-based insurance authorizations.Serves as the system of record for agencies to access and maintain service authorizations. -
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Olio
Olio
Simplify case management efforts with post-acute providers and operationalize value-based care. Get real-time feedback and intervene when appropriate for all your PAC network patients. Get immediate support from your acute partners. Improve quality and patient outcomes and form stronger referral partnerships along the way. Have a seat a the table with Olio and succeed in value-based care. Population health leadership have tried to improve PAC performance. They started with evaluating their PAC providers and the industry evolved from there. PAC providers don't have the resources, experience, or knowledge to execute your complex population health strategy. You are asking them to do more with less. Olio helps modernize communication to your PAC network and give your entire team the resources to execute your population health strategy. -
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Inovalon Data Cloud
Inovalon
Our industry-leading primary source dataset represents the largest, most diverse resource for researchers and analysts across healthcare to derive deep insights for the improvement of health outcomes and economics. Advance the future of healthcare with relevant data extracts across the range of care that include robust provider identification, a linkable view of the patient journey, and the ability to safely link to external data sources. Accelerate research and improve healthcare outcomes with longitudinally linkable, deidentified real-world data. We perform more than 1,100 data integrity checks to ensure consistency and accuracy, applying industry-standard practices for quality assurance and ease of integration. Discover new insights with rich, relevant real-world data. Use custom extracts from open and closed primary sources to accelerate research and advance clinical outcomes and provider performance. -
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Agilum
Agilum
We enable the leap to value-based care by comparing treatments, drugs, processes, and costs to help hospitals, life science companies, and payers identify treatment plans that achieve the best patient outcomes. Our CRCA™ P&T platform empowers P&T committees to yield data-driven improvements in quality metrics, such as average length of stay (ALOS) and 30-day readmissions. Our unique POP-BUILDER Rx™ solution provides comparative analyses between selected cohorts and CRCA’s real-world data index of over 140MM longitudinal patient records. Our drug remittance dashboard analyzes and reports drug remittance data across payer types and for focused groups of high-cost drugs down to the NDC level. We help hospital finance departments quickly and easily monitor and improve service line costing and profitability, productivity, and revenue cycle performance via insightful analytics, reporting, and our Agilum Healthcare Intelligence team. -
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OMS Trace Analytics
Objective Medical Systems
Enhance value-based care with the OMS Trace Analytics® cloud platform for the analysis and reporting of critical cardiovascular metrics. Increasingly reimbursement is being tied to value. For example, for the performance year 2018, 60% of Medicare reimbursements are being linked to quality under the Quality Payment Program. The need for a discrete data and evidence-based quality reporting solution to measure, target and improve your quality program is more critical than ever. The OMS Trace Analytics® cloud platform is designed to deliver deep clinical insights for cardiovascular diseases with dedicated dashboards for leading cardiovascular diseases like Hypertension, Dyslipidemia, Atrial Fibrillation, Heart Failure, Coronary Artery Disease and Peripheral Artery Disease. -
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William
Certifi
Certifi's William is an intelligent automated premium billing and payments platform that performs all the functions of membership accounting, payment management, collections, and remittance for digital benefits-based billing. William enables 100% electronic billing transactions in complex billing scenarios, including payer-sponsored marketplaces for group and individual populations, as well as unique populations like Medicare Advantage and Medicaid. As a true enterprise-class accounting system, William offers GAAP-compliant reporting with clear audit trails for general ledger management. All customer-facing bills, reports, portals, and tools are branded to be consistent with your organization's brand. The platform delivers rules-based delinquency and termination communications, from notification to policy suspension and termination. Consumers and employers can set up individual or recurring payments using their preferred payment methods. -
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MEDENT
Community Computer Service
MACRA impacts all providers with $90,000+ in Part B charges that are treating more than 200 Medicare beneficiaries. Physicians ranked compared to peers, with potential negative adjustments to total Medicare revenue. Two reimbursement programs: MIPS and Advanced APMs. The Patient Portal is a powerful tool that can modernize the way your office communicates with patients. The tools built into the MEDENT system are second to none when it comes to managing your practice. Our EMR/EHR was developed from the ground up with a focus on efficiency and reliability. -
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Perception Health CARE
Perception Health
Manage risk more effectively and provide better care to your population with the disease prediction models in CARE™. We have a nationwide view of medical claims data that is customizable to the most micro-level for our customers. Our models analyze billions of medical claims to identify risk factors of early disease onset or surgical procedure. With this information, diagnosis and treatment happen earlier, potentially saving lives. We train our prediction models using national data, but we can also run our models on data from your EHR, population health platform, or member claims database. Furthermore, our physician matching can help you select and match providers to patients in order to optimize their care pathway for the best treatment. Our advanced disease prediction models use clinically relevant data to show who is trending towards a diagnosis of a disease or condition, allowing you to engage with them sooner to begin treatment. -
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ActiveHealth CareEngine
ActiveHealth
Your organization will be healthiest when your people are, too. The power of integrated data, consumer, behavioral, pharmacy, clinical, device, financial, provider and more, help us find opportunities at the population and personal level. That’s CareEngine technology. We translate and analyze this data using peer-reviewed, evidence-based clinical analytics to find opportunities to improve care. Program identification, synchronized digital experience, insights for coaches and clinicians, prioritized health actions for members. Integrations with provider EMR, care ConsiderationSM alerts for providers. We specialize in engaging and advocating for disengaged, vulnerable members who often have multiple medical, behavioral and social challenges. We're uniquely positioned to meaningfully improve health outcomes and costs. ActiveHealth has been fully accredited by URAC in health utilization management since 1992. -
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OpenLoop
OpenLoop Health
OpenLoop is a fully white-label telehealth platform designed to help organizations launch and scale virtual care quickly and efficiently. It provides end-to-end telehealth infrastructure, including technology, clinical staffing, licensing, credentialing, and regulatory support. Built to integrate seamlessly with existing systems, OpenLoop supports both synchronous and asynchronous care models. It is trusted by millions of patients annually and operates across all 50 U.S. states. OpenLoop enables organizations to deliver branded telehealth experiences with scheduling, payments, and patient support included. Nationwide payer coverage, including Medicare and Medicaid, simplifies reimbursement and revenue cycle management. With AI-powered operations and 24/7 patient support, OpenLoop helps organizations scale care while maintaining quality and compliance.Starting Price: Free -
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Change Healthcare Data & Analytics
Change Healthcare
Access comprehensive, timely data to help improve patient outcomes, reduce costs, and grow your business. Our solutions unlock the power of your data for comprehensive views of your patients, members, prospects, organization, and community to help you improve quality of care, increase revenue, and meet compliance guidelines. Our solutions use statistically significant, deidentified, targeted data sets to help you understand local, regional, and national trends related to healthcare use, population health, and the impact of social determinants of health. Find and share knowledge, exchange ideas, and collaborate with peers and Change Healthcare experts to drive your solutions to success. Attract and impress patients with a seamless, unified experience that drives engagement, loyalty, and revenue. Empower your patients to shop for services, schedule appointments, complete forms, and pay for care on their own digital devices. -
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Truveta
Truveta
Truveta is a health data and analytics platform dedicated to saving lives with data. By aggregating de-identified electronic health records from over 30 health systems, Truveta offers researchers access to comprehensive patient data, including clinical notes, images, and genomics. This extensive dataset encompasses more than 120 million patients, providing a representative view of patient care across the United States. Truveta Studio, the platform's integrated analytics solution, empowers researchers to analyze precise populations with powerful tools, including notebooks and dashboards, all within a secure, HIPAA-compliant environment. The platform's data is updated daily, ensuring timely insights into patient care and outcomes. Truveta's commitment to data quality is evident through its use of the Truveta Language Model, a large-language, multi-modal AI model designed to transform EHR data into clean and accurate data points for medical research. -
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HealthEC
HealthEC
HealthEC’s best population health management platform, comprising our care management module CareConnect™ and our analytics module 3D Analytics™ - is designed to elevate quality of care and patient experience by overcoming the healthcare industry's toughest data challenges. Conquer system chaos with a universal data warehouse of normalized claims, clinical, and SDoH data, from any source. CMS certified for reuse. Eliminate workflow disruption with integrated, customizable care plans, decision-support tools and robust care management support. Deliver patient-centric care by seamlessly coordinating with community resources and addressing social determinants of health. Inform strategies with actionable insights at the diagnosis, provider, practice, and organizational levels, presented in clear dashboards or at the point of care. Enhanced MCO performance reviews and CMS interoperability rule compliance. -
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EnsoData
EnsoData
We believe that Waveform AI can help the healthcare system in so many ways, and we’re building a platform to empower clinicians with useful information and support across the care continuum. “It takes a village” to transform healthcare, and to contribute to advancing the field, we’re publishing peer-reviewed AI research to show where and how AI will benefit every step of the patient care journey. Help providers identify patients with a high risk for sleep apnea using data from EMR, waveforms, wearables, and a multitude of sources and refer patients for diagnosis. Use data to help providers identify the most critical patients in the massive undiagnosed population by stratifying patients by risk for adverse outcomes and potential costs. Help clinicians bring patients through the diagnostic process and get more patients treated more quickly by optimizing efficiency, cost, and quality of sleep apnea diagnosis.Starting Price: $8.25 per month -
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Lightbeam
Lightbeam
Lightbeam provides population health enablement by transforming insights into outcomes. Closing care gaps and minimizing risks. Improving quality of care and quality of life. Lightbeam’s proven population health management platform transforms disparate data into a full 360-degree patient picture, bringing true value to value-based care. In today’s value-based care model, managing risk begins and ends with data intelligence. Lightbeam’s powerful population health management platform pulls patient data together in unprecedented ways, unlocking the value that comes from deploying the right data in the right place at the right time. Lightbeam isn’t just revolutionizing how our clients manage value-based care. It’s proving to be a game changer in driving results and saving our clients over 2 billion dollars since 2014 and we’re just getting started. Lightbeam’s tech-enabled services approach seamlessly supports these efforts. -
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Interpreta Clinical Action
Interpreta
Interpreta’s Clinical Action is the single platform for in-year quality and risk intervention with NCQA certification in HEDIS and California IHA AMP since 2015. Clinical Action uses HEDIS, state-specific, and HCC formulations to provide a large library of quality and risk measures available in a cloud-based platform for direct user access or through easy integration with provider group and health plan ecosystems. Clinical Action automates workflows for structured medical, lab, and pharmacy claims data and provides a robust unstructured supplemental data environment for code capture and integration with artificial intelligence and machine learning (natural language processing) solutions. Clinical Action’s customizable population capability allows for care gap analytics from a full population health view down to the single member for in-office physician preparation. -
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Providing a secure, cloud-based platform, longitudinal EHR data, and analytic tools to help providers and life sciences companies find new connections among previously siloed healthcare data. A set of SaaS applications designed to enable rapid population management, performance measurement, and effective engagement to patients and providers. Enables healthcare systems to collect, link, and combine data from hundreds of disparate sources across their enterprise and clinically integrated networks. Enables care and quality program designers to search and browse populations surrounding diagnoses, treatment, outcomes, costs and demographics. Quickly identifies target populations to help you make better decisions about risk-stratified care management. An integrated framework for correlating billions of clinical, operational and financial events into benchmarks and scorecards for comparison.
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CloudMedx
CloudMedx
Activate and unify your data with our secure connected healthcare platform. Powered by APIs, data integration capabilities, and a suite of platform services and interoperable tools to enhance your existing applications and care delivery workflows. Activate all your data today to build a connected health platform. DataMedx creates a Health Data Mesh (HDM) for your organization that is powered by APIs, data integration capabilities, and a suite of platform services and interoperable tools in order to enhance your existing applications and care delivery workflows. DataMedx aggregates and normalizes data from all your data sources (claims, clinical, labs, sensors etc.) and brings them into one unified patient record. Complete populations from multiple applications can now be accessed with a single data visualization layer resulting in superior patient outcomes and operational excellence. -
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Innovaccer
Innovaccer
We help providers integrate disparate patient data to deliver actionable insights at the point of care, collaborate across care teams, and achieve better health outcomes. We help drive collaboration and connectivity among payers, providers, and members to manage risk, costs, compliance, and rising member expectations. We help biopharma and medtech companies build digital solutions at their intersection with healthcare and better leverage real-world data across the value chain. Unify patient data, generate comprehensive clinical and financial insights, and innovate faster. Move beyond silos to an open, secure platform that unifies healthcare data into a single, longitudinal patient record that enables whole-person care. Rapidly develop interoperable solutions and accelerate digital strategies through our developer tool suite and open APIs. Customizable analytics and advanced insights help enhance care quality, reduce costs, and improve clinical and financial outcomes for providers. -
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CareTime
CareTime
Built for usability and power—CareTime is a cloud-based desktop and mobile software solution for home health, home care, and consumer-directed care markets. Find the best fit based on client requirements, preferences, distance, hours worked, and caregiver availability. Invite caregivers to accept a shift through text message or email. Shifts are filled on a first-come-first-serve basis. Track visits and automatically create billing and payroll data from check ins and check outs. Record visit notes and questions. Admins have the ability to see caregivers and visits on a map. Alerts notify if visits are missed, caregivers are late, authorized hours are running out and more. Create and send electronic claims to get paid by insurance, Medicaid, Medicare, and more. Batch claims can be created in an instant from all of your visit data. -
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Humhealth
HUMHEALTH
Humhealth supports group of Medicare programs include Chronic Care Management, Remote Patient Monitoring and other programs. Humhealth software promotes the Practices to the next level of patient care. Humhealth Chronic Care Management provides specifically designed work flow that includes Adding verbal/written Consent, Enrolling patients, Create and Update Comprehensive unique Care plan for each patient with chronic conditions. Creating call follow ups for the monthly CCM with reminders, Automated inbuilt timer to calculate the service time of the care team. Monthly billing report to support the reimbursement for the practices. Humhealth Remote Patient Monitoring devices with various technology makes the practices choose from 4G, Bluetooth, Gateway hub integrated with web platform for the real time vital tracking of the patients and automated text message to remind the patient to take the missed readings to ease the work of the practices.Starting Price: $95 per month -
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Care Management Suite
Health Catalyst
The Care Management Suite is a data-driven care management solution with tools and processes that deliver visibility across the continuum for high-risk and at-risk populations, facilitate more streamlined and patient-centric workflows, improve the quality of patient care, and reduce overall costs. With data analytics revealing opportunities for improvement throughout the process, the Care Management Suite improves clinical, operational, and financial outcomes. The Care Management Suite consists of three applications: Population Builder™: Stratification Module, Population Care Workflow, and Population Care Insights. An end-to-end, streamlined workflow for everything from patient enrollment, active care management, patient records, and care coordination between all care team members saves time and improves care. An analytics-driven DOS platform aggregates disparate claims and EMR data to provide a comprehensive patient view. -
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Intus Care
Intus Care
Intus Care is a healthcare analytics platform that synthesizes healthcare data to identify risks, visualize trends, and optimize care; ready to spearhead your organization in as few as six weeks. Intus Care empowers care providers to mitigate high-risk events and equips executives with the tools to make informed decisions based on data. Our ICS specialists work alongside your leadership and staff to improve participant and organizational outcomes in your PACE program. Intus Care is a team passionate about people. We are driven by the needs of all people, patients, families, and caretakers alike. Our mission is to catalyze data-driven change to achieve high-value, multidisciplinary care for older adults. Patients are at high risk for hospitalizations, readmissions, and the onset of chronic diseases. Overall expenditures through early patient risk detection. Organizational performance through trend analysis and best practice identification. -
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The Digital Health Indicator measures progress toward a digital health ecosystem. An ecosystem that connects clinicians and provider teams with people, enabling them to manage their health and wellness using digital tools in a secure and private environment whenever and wherever care is needed. Operational and care delivery processes are outcomes-driven, informed by data and real-world evidence to achieve exceptional quality, safety and performance that is sustainable. Based in the principles and evidence of the HIMSS Digital Health Framework, the DHI measures four dimensions that are proven to help your organization advance digital health transformation. Build governance to support a sustainable workforce using outcomes data. Flow data seamlessly across the health system in real-time. Proactively prioritize population health outcomes, informed by robust analytics, with real-time tracking.
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Ember
MetiStream
Unite and free your unstructured health data Interactive AI and NLP solution delivering health insights to Providers. Payers. Life Sciences. Interactive AI and NLP solution to unlock health insights from unstructured clinical notes data for: Provider. Accelerate data abstraction from and clinical validation of information contained in clinical notes. Decrease time and reduce costs required to identify care gaps, review care quality dashboards, and generate registry reports. Payer. Integrate and analyze both claims data and clinical notes to more effectively manage high risk and high cost member cohorts. Life Sciences. Rapidly match patients to clinical trials–and vice versa–using clinical trial databases and data from clinical notes. Leverage the power of real world clinical data and evidence. Ember is an end-to-end solution at the intersection of NLP and predictive analytics. Streamline. Healthcare Analytics for Unstructured Data to Improve Quality, Efficiency, and Outcomes -
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Approved Admissions
Approved Admissions
Approved Admissions is a secure platform that automates tracking of coverage changes for Medicare, Medicaid, and commercial payers bundled with real-time eligibility verification and coverage discovery. The platform's primary goal is to help providers minimize the number of claim denials due to a missed insurance coverage change and accelerate the billing cycle. Approved Admissions is using the innovative RPA (Robotic Process Automation) Bridge solution to ensure patient data consistency across multiple systems, and benefit coverage search. Key Features: - Automated eligibility verifications and re-verifications - Email or API notifications if any coverage changes are detected - Real-time verifications - Batch eligibility verification - Seamless integration with RCM, EHR platforms (PointClickCare, MatrixCare, SigmaCare, DKS/Census, FacilitEase, and many others) - RPA-powered cross/platform synchronizationStarting Price: $100 per month -
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SapphireVantage
Novacis Digital
SapphireVantage is an AI-powered health analytics and performance management platform built for healthcare payors, providers, and large programs that need a 360° view of performance and actionable insights across clinical, financial, and operational domains. It harnesses advanced data analytics and artificial intelligence to integrate and analyze diverse healthcare datasets in real time, offering capabilities such as claims analytics, utilization analytics, risk and program integrity analysis, provider performance, consumer engagement metrics, care analytics, denial trends and prevention, contract performance, revenue cycle optimization, and fraud/waste/abuse detection to help organizations improve quality, control costs, boost efficiency, and enhance patient outcomes. It supports self-service analytics, real-time dashboards, predictive insights, and performance monitoring tools to empower data-driven decision-making and reveal underlying patterns and outliers. -
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Patients don’t look any different, not in person, not in their EHRs and not on their claims, but they are. And for someone who is high-risk, spotting that difference early can determine the shape and severity of their care. Today, patients can get something new in the exam room: advanced analytics in real-time. Diabetes patients entering one ER were entered into a real-time analytics platform Amitech had created that enabled caregivers to ID at-risk individuals on the spot, drastically improving clinical outcomes. It’s just one example of how new data sets coupled with pinpoint, cutting-edge analytics can help insurers and caregivers take action in the moments that matter. Advanced analytics does indeed hold huge promise for helping healthcare organizations spot inefficiencies and unseen areas of opportunity. A precise strategy that begins with an in-depth assessment to identify the value opportunities for your organization is key to capitalizing on data’s true potential.
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ReferWell
ReferWell
Payers and provider networks covering more than 10 million lives have managed 200,000 care transitions with ReferWell. Improve medicare advantage, member experience, and care gap closure for quality improvement. Improve network adequacy across disparate EMRs while reducing costly transitions and eliminating leakage. Improve access to care and identify new 340B revenue to support care for the community. Strengthen relationships with community providers, direct care to the right hospital specialists, and reduce revenue leakage. ReferWell is fully HIPAA compliant and integrates with all of the major EMRs and scheduling platforms in order to facilitate the sharing of clinical data between providers to improve the coordination of care, all while wasting less time on the phone and fax. ReferWell supports all integration protocols. The ReferWell solution empowers provider networks to guide patient and member care transitions and gain full visibility into all patient and provider behaviors. -
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Centauri Health Solutions
Centauri Health Solutions
Centauri Health Solutions is a healthcare technology and services company driven by our desire to make the healthcare system work better for our clients and to provide compassionate support for individuals in need. Our analytics-powered software enables hospitals and health plans (Medicare, Medicaid, Exchange and Commercial) to manage their variable revenue through a custom-built workflow platform. While our tailored support of their patients and members provides them with access to life-enhancing benefits. Our solutions include Risk Adjustment (Medical Record Retrieval, Medical Record Coding, Analytics and RAPS/EDPS Submissions), HEDIS® and Stars Quality Program Management, Clinical Data Exchange, Eligibility and Enrollment, Out-of-State Medicaid Account Management, Revenue Cycle Analytics, Referral Management & Analytics, and Social Determinants of Health. -
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PremiereConnect
Premier Inc.
From reducing costs to providing unmatched clinical insight, Premier helps health systems focus on what they do best. HealFirst. The PHMC approach condenses the learning curve for organizations to improve care delivery, quality and efficiency; enhance the patient experience; generate higher margins; and optimize hospital-clinician alignment while advancing toward population health management success. Organizations can visualize their ACO populations’ cost and medical utilization by key service categories compared to national and well-managed benchmarks. This allows them to effectuate change faster within their ACO at the facility and beneficiary levels. Additionally, the platform allows groups to quickly stratify their opportunities and measure ROI so they can focus on the areas with the greatest potential return. -
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Oracle Healthcare Analytics
Oracle
Use the latest cloud analytics and data science technologies to analyze healthcare data and build new AI applications. Create evidence-based care models and understand how to improve patient experiences and clinician satisfaction. Reduce the cost of care and enhance population health. Oracle Autonomous Data Warehouse is a cloud data warehouse that eliminates all the complexities of operating a data warehouse and developing data-driven applications, including database management and security. Store, manage and use your data easily with a seamlessly integrated set of data ingestion, preparation, and machine learning (ML) tools. Use your insights to develop evidence-based care and precision medicine models. Empower executives, analysts, and IT staff to access business intelligence from wherever they are, in the office or at your clinics. Jump-start your analyses with automated data preparation and built-in ML. -
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SmartEMR
SmartEMR Solutions
SmartEMR is a Web-based electronic medical records solution that enables physicians to record patient encounters and test interpretations quickly and easily. It's tailored to the physician's workflow to ensure a smooth, natural interaction while creating reports that are compliant with the Centers for Medicare and Medicaid Services (CMS)* for coding and reimbursements. SmartEMR also works as a medical billing software, facilitating reimbursement by using our CMS-compliant Superbill generation module. Your electronically submitted claims will be processed with a higher priority ensuring faster turnaround time for reimbursement. SmartEMR will improve your cash flow, by reducing costs and streamlining the entire process for reimbursement.4 -
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Hospice Tools
Hospice Tools
Built from the ground up by a team of hospice pros with decades+ of hospice experience. From our super-fast IDG & smart care planning to hassle-free room & board, Hospice Tools helps your team with solutions that support how they work. Get intuitive charting everywhere with access on the Web & with our one-of-a-kind mobile apps! Our flexible forms & reports are completely customizable to match your workflows and our automatic compliance features, built-in timesheets and billing tools ensures your teams’ success! Medicare real-time claim status. Built-in appeals tracking. Fast and accurate billing with all payers including Medicaid room & board! Built for hospice & palliative agencies. Customizable forms & reports. Fast and seamless charting, smart care plans, super-fast IDG, automatic compliance, mobile apps and more!Starting Price: $85 per user per month -
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EZClaim Medical Billing
EZClaim
EZClaim is a medical billing and scheduling software company that provides a feature-rich practice management system specifically tailored for small to medium-sized provider office and outsourced medical billing firms. It also includes integrations with a number of EMR/EHR vendors. Whether you are a doctor, practice manager, or billing service owner, EZClaim Billing is designed with you in mind, simplifying your claims management from data entry to payment posting, and beyond. EZClaim primarily supports the following specialties, General Practice, Therapy, Vision, Surgical, Medical Specialties, Home Health Care, and Outsourced Medical Billing Services (RCM). However, the software is very adaptable and can be used for many other billing specialties. EZClaim’s billing software allows the creation of insurance payor lists for Medicare, Medicaid, Tricare, Clearinghouse payer IDs, governmental MCO’s, auto insurance, and worker compensation groups. -
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Talix
Talix
The Talix platform powers intelligent workflow applications that enable risk-bearing healthcare organizations to succeed in the age of value-based care. Our workflow solutions for payers and providers require intelligent underlying technologies to work in unison and at scale. We’ve engineered the Talix Platform to support the needs of thousands of end-users, anywhere in the world simultaneously. Moreover, our platform architecture enables multiple SaaS application solutions in order to harness the efficiencies derived from being able to process millions of patient charts and encounter data. The Talix Platform is comprised of several technology components, intricately linked, to power software applications at scale for healthcare payers and providers. These components form the building blocks of artificial intelligence (AI).
