CMS and Commercial payors are aiming to transition over 50% of beneficiaries to value based payments by 2020. This is a complex undertaking for providers, ACOs and payors as it requires significant transformational change in provider culture, medical decision making and operational processes to take on upside and downside risk. CapsicoHealth addresses these challenges through proven methods and technology.
CapsicoHealth's automated data platform and AI tools (with forecasting, what-if-models, predictive analytics and NLP) unlock key insights from hundreds of millions of claims, social, cost and EMR data, and enable providers to create new risk sharing models and manage complex a range of CMS and commercial contracts (e.g. CJR, BPCI, Capitated models and OCM) with minimal transactional costs. Our solutions drive 99% accuracy in data quality, 15% reduction in operational costs, over 80% accuracy in identifying negative outcomes (e.g. hospitalizations), and 90% savings on manual steps needed to generate insights.