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Resources | Apixio – old

events

events

RISE National 2025

RISE National is the #1 trusted source for all things Medicare Advantage, crossing a variety of topics and themes from risk adjustment and quality to member experience and social determinants of health.

press

press

Datavant Acquires Apixio’s AI-Based Connected Care Platform and Value-Based Solutions

Datavant expands capabilities to give healthcare organizations a comprehensive view of patient health with modern digital toolset Company acquires Apixio’s AI-based Connected Care platform and value-based solutions to propel the shift to an outcomes-based healthcare system by unlocking the value of data NEW YORK, September 10, 2024 – Datavant, the leading health data platform company, […]

press

press

The Rawlings Group, Apixio Payment Integrity, and VARIS Merge to Form Next-Generation Payment Accuracy and Integrity Platform

The comprehensive, technology-enabled platform will leverage data and artificial intelligence to reduce healthcare costs for health plan clients NEW YORK & DALLAS, September 5, 2024 – New Mountain Capital, LLC (“New Mountain”), a leading growth-oriented investment firm with over $55 billion in assets under management, today announced the completion of a merger among The Rawlings […]

industry blog

industry blog

Navigating the Path to V28 Model: Developing Your Risk Adjustment Strategy

The healthcare coding landscape for Medicare Advantage (MA) significantly shifts based on the transition from the V24 to the V28 Hierarchical Condition Category (HCC) risk adjustment model. This evolution profoundly impacts health plans and providers, necessitating an understanding of the changes and their implications. Let’s explore what this shift entails and how organizations can navigate […]

guides + white papers

guides + white papers

Demystifying the Complexities of Pre-Payment for Long-Term Business Success

Transitioning from post-pay to pre-pay can significantly benefit your payment integrity program. It’s crucial to recognize that the advantages of pre-payment extend beyond just operational improvements. With the right solutions partner offering technologically advanced solutions tailored to your health plan’s unique requirements, you can achieve results that drive success, ensuring enhanced effectiveness and efficiency in […]

article

article

Closing Care Gaps Through Prospective Risk Adjustment

Our CEO, Sachin Patel, explains how risk-bearing organizations can use AI-powered solutions to overcome risk adjustment obstacles and confidently shift toward a prospective program that will help enable improved patient outcomes, regulatory compliance, and provider resiliency.

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Additional Content

guides + white papers

guides + white papers

Apixio’s Guide to Enhancing Payer-Provider Collaboration Through Prospective Risk Adjustment

Apixio guides you through innovative strategies to support payer strategies and provider engagement and empower clinical teams to implement or improve collaborative prospective risk adjustment practices. Download the eBook to explore more.

industry blog

industry blog

Paths to Success with ACA Risk Adjustment

Prior to the COVID-19 pandemic, risk capture was almost an afterthought for ACA populations. Today, it’s an integral part of any risk adjustment program. The 2023 benefit year alone is resulting in $10.3B in transfer payments. Today, we want to discuss what’s driving it and how the right risk adjustment partner can help ensure the […]

article

article

Enhancing Payment Integrity in Healthcare through Pre-Payment Reviews

Our President & Chief Operating Officer, Tom Magnotta, explains why payment integrity is essential for ensuring financial accuracy, maintaining compliance with regulations, optimizing the healthcare delivery system, and removing administrative waste, which impacts the focus on patient care and quality outcomes. It also plays a crucial role in reducing overall healthcare costs and indirectly affects […]

webinars

webinars

The Complete Guide to Evaluating Pre-Pay DRG Solutions

As technological advancements progress, the trend toward pre-payment reviews is rising. Developing an effective pre-pay DRG strategy still demands dedication and collaboration with the right partner. Learn how to select the best pre-pay DRG solution to maximize payment accuracy and reduce administrative costs. In this webinar, we will deep dive into: Establishing goals to be […]

press

press

Apixio Receives the 2024 American Business Award in the AI/ML Solution – Healthcare Category

Apixio has been recognized for the second year in a row by The Stevie® Awards as a Bronze winner in The 22nd Annual American Business Awards®, AI/ML Solution – Healthcare category. Our Prospective Risk Adjustment Suite was selected because it can transform how healthcare providers interact with data, improve patient care, and streamline clinical workflows. […]

industry blog

industry blog

Navigating Payment Integrity: Strategies for Success in 2024

The intricacies of payment integrity hold the industry in a perpetual state of adaptation. With data integrity and fiscal responsibility at the forefront, health plans need to manage cost containment efforts by driving down administrative costs and harnessing the power of technology. With shifting priorities, payers are prioritizing across all lines of businesses to directly […]

case studies

case studies

Client Spotlight for Pre-Payment

See how one of the nation’s largest health plan transformed their payment integrity program and realized more than $1 billion in cost avoidance. Download the full case study to see more results of the study.

brochures

brochures

Revolutionizing Retrospective Risk Adjustment Coding Operations with AI-Driven Insights

Apixio’s AI-as-a-Service Solution for Retrospective Risk Adjustment enables payers and other healthcare organizations to identify diagnoses accurately and efficiently within their existing coding workflow applications.

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