Case Study

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AI for population risk

How a rapidly growing ACO expanded value-based care with Reveleer

Business Challenges


An ACO planned to grow aggressively in 2023 but needed to better understand the health status of patient populations acquired into its network to improve care.

At the same time, legacy processes relied too heavily on professional coders to manually review clinical documentation and struggled to scale.

Key Highlights


  • 70K patients
  • 93% new patient data
  • 82% HCC reviewed by provider

Solution:
AI platform for Prospective Risk Adjustment

The ACO explored solutions and partnered with Reveleer, believing our data acquisition capabilities and the speed and accuracy of our AI-enabled platform would best help scale their business.

Our AI synthesizes and analyzes a nationwide network of clinical data to create patient summaries with undiagnosed Hierarchical Condition Category (HCC) codes with links to supporting clinical documentation.

Reveleer pushes this information into provider workflows at the point of care for more precise, clinical decision making, such as earlier diagnosis detection.

75+

National and Regional HIEs

70,000

Medical Groups

5,800

Dialysis Centers

90%

Of All Hospitals

Clinical insights to drive better outcomes

The company leveraged Reveleer for Prospective Risk Adjustment to cover more than 70,000 patients, supplementing their in-house data with Reveleer's data interoperability and AI-powered clinical insights.

From the provider's perspective, the solution delivers timely, evidence-based clinical insights that directly impact patient outcomes while streamlining pre- and post-encounter workflows.

The ACO continues to work with Reveleer to on-board new provider groups, arming them with clinical insights that create opportunities for early detection and better care.


  • 93%
    Patients with New Clinical Data
  • 82%
    Had New HCCs Reviewed by Providers
  • 0.33
    RAF Uplift Opportunity Across Patient Population
  • <2 Weeks
    Retrieval Time Compared to Months Prior to Reveleer Solution