Transform Raw Data into Actionable Insights
Discover our analytical impact on prospective risk adjustment for Medicaid plans under the CDPS + Rx model.
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.
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.
Additional Resources
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