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Transform Raw Data into Actionable Insights

Discover our analytical impact on prospective risk adjustment for Medicaid plans under the CDPS + Rx model.

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Fuel Your Prospective Care Programs with Advanced Analytics

Episource Analyst is more than an analytics tool. It’s a comprehensive risk-adjustment analytics workflow platform that turns data into actionable insights at the touch of a button.

With Analyst, Medicaid health plans can launch and track campaigns to close risk score gaps, execute targeted interventions, and improve quality of care for your members — all within a single application. 

Key Features

Risk Adjustment Suspecting

Leverage risk adjustment suspecting and gap analytics based on historical data with simple workflows to manage prospective, concurrent, and retrospective campaigns.

Streamlined UI

Customize your member- and provider-level reports and easily view campaign performance metrics, such as total eligible members and top 5 suspected and captured HCCs with our intuitive UI.

SDOH Analysis

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.

Chase Lists

Generate chase lists by prioritizing high-risk members for more immediate care.

Member & Provider Stratification

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.

How You'll Benefit

Prospectively identify and close CDPS gaps

Generate provider education and partnership strategies

Support member engagement programs

Drive primary and specialty care by analyzing gaps

Support case management for high-risk members

Leverage member stratification to maximize program impact

Our Impact

"...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."

Episource Client

"You guys have put thought into things and understand risk. It's not just risk scores, it is so much more."

Episource Client

"Seeing the impact that we have on our providers has made it all worth it."

Episource Client

Master Medicaid Complexities with Advanced Analytics

We innovate for all health plans operating under the CDPS + Rx, CDPS, and Medicaid Rx models and handle all state-level definitions and complexities.

 We also offer coding and submissions services to help you confidently submit accurate claims before CMS deadlines.

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Additional Resources

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