New Resource: HCC Tearsheet 2025. Access Now!
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New Resource: HCC Tearsheet 2025. Access Now!
Episource Analyst is more than an analytics tool. It’s a comprehensive risk adjustment analytics platform that turns data into actionable insights at the touch of a button.
With Analyst, your health plan can launch and track campaigns to close risk score gaps and improve quality of care — all within a single application.
Leverage risk adjustment suspecting and gap analytics based on historical data with simple workflows to manage prospective, concurrent, and retrospective campaigns.
Generate chase lists by prioritizing high-risk members for more immediate care.
Stratify members and providers by numerous data points and attributes, including risk scores, disease gaps, prevalence, eligibility, provider types, and more for direct, targeted impact at campaign or program levels.
Customize your member- and provider-level reports and easily view campaign performance metrics, such as total eligible members and top five suspected and captured HCCs with our intuitive UI.
Create member cohorts based on social determinants of health (SDOH) factors, including age, gender, zip code, race, and ethnicity. Then, leverage this analysis to identify which member segments need additional care or services.
Drive primary and specialty care by analyzing gaps
Support case management for high-risk members
Leverage member stratification to maximize program impact
Support member engagement programs
Generate provider education and partnership strategies
Drastically reduce workflow inefficiencies
increase for one client after just two years of implementation
in potential revenue opportunity uncovered for that one client
When you establish a new relationship, you set some expectations, and some are lacking, some just meet expectations, and then you have that one or two who will exceed expectations — and that is Episource for us.
You guys have put thought into things and understand risk. It’s not just risk scores, it is so much more.
They’ve added in features where we can actually see the campaigns in real time and watch it progress through the dashboards and get all kinds of great reporting.
Seamlessly Transition to the V28 Model with Episource Analyst
In early 2023, the Centers for Medicare & Medicaid Services (CMS) announced the transition to Version 28 of the CMS-HCC model. The V28 model is expected to decrease Medicare Advantage risk scores by an average of 3.56% in 2024. Episource Analyst can help you plan ahead with:
Our analytics technology ingests your member data to estimate the potential decrease in risk scores and RAF opportunities for your risk adjustment program.
We’ll provide you with a more accurate risk assessment of your member population based on the changes to unique HCCs and HCC mapping.
Our experts will share strategies for counteracting a decline in risk scores, such as developing prospective care programs and improving member engagement.
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