October 31 2017

Clarify Health Expands Value-Based Payment Offerings with Cutting-Edge Solution for BPCI, Commercial Bundles and Medicare Advantage

Predictive analytics solution empowers physicians, health systems, ACOs and payers to thrive in bundled payments, capitation and population health management

SAN FRANCISCO, Oct. 31, 2017 /PRNewswire/ — Clarify Health Solutions, Inc., a pioneer in AI-enabled care optimization, today unveiled the most advanced bundled payment and population risk management platform currently on the market.

The significant expansion of Clarify Health’s value-based care technology solutions addresses several industry pain points. The Centers for Medicare & Medicaid Services (CMS) is expected to announce new, voluntary bundled payment programs in the coming months, including BPCI. Meanwhile, health systems and physician groups continue to grow their footprint in capitated and population risk arrangements such as Medicare Advantage, ACOs, and provider-owned health plans.

“To confidently take on risk for populations and bundled payments, physicians and health systems need to have patient-level predictive insights to optimize care,” said Mark Froimson, M.D., president of the American Association of Hip and Knee Surgeons (AAHKS), and former chief clinical officer and executive vice president of Trinity Health Corporation. “Clarify Health’s differentiator is the speed and agility with which their solutions generate specific insights and empower clinicians to immediately translate them into better care for the patients they serve.”

Clarify Health’s care optimization analytics power an end-to-end view of value creation across populations and care journeys. Physicians, providers and payers have access to a “care command center,” which provides visibility into the care journeys of their in-flight patients across the continuum of care. By delivering actionable insights, the Clarify Health platform quickly scales to power success in any bundle or population risk arrangement.

“The healthcare industry is undergoing a massive transfer of risk from payers to physicians and health systems,” said Jean Drouin, MD, MBA, CEO and co-founder of Clarify Health. “The winners in the new world of value-based care will be those organizations that successfully deploy the same type of advanced technologies and applications used by banks, airlines and companies like Amazon. We believe in making these solutions widely available to physicians and health systems so they can deliver great care and control their destiny.”

The Clarify Difference
Clarify Health’s care optimization and value-based payment offerings leverage the company’s deep experience in healthcare and the financial industry, as well as Big Data and AI capabilities drawn from Silicon Valley, to deliver an affordable, scalable solution for BPCI, commercial bundles and other value-based arrangements.

“I’m enormously energized by the passion, vision, and execution of the Clarify Health team,” said Dr. Jack Cochran, former executive director and CEO of the Permanente Federation. “Clarify is creating breakthrough applications that would be welcome and very useful to integrated systems of care delivery, like Kaiser Permanente, as well as to insurance companies, hospitals and physician groups.”

He added, “Their expert team, which has a track record of (and the scars from) achieving over $1 billion in improvement across payers and providers, has seamlessly translated the latest technologies applied in other industries through the healthcare lens. They are cracking the code on automating not only improved care delivery but also sustained culture change. This is making medicine cool again!”

Clarify Health’s cloud-based, data lake architecture seamlessly integrates clinical, claims, social determinant and patient-reported data, and then applies the industry’s most advanced, AI-driven analytics engine to help organizations:

Illuminate: Rapidly link siloed data sets at individual patient level to unmask addressable variation and immediately generate care improvement insights.
Design: Use predictive analytic models trained on data from over 100 million lives to quickly identify which risk to take and with whom to partner. Test attribution methods, determine which episodes of care are optimal for bundled payment programs, make critical design decisions (e.g., duration, exclusions), and understand the range of acceptable prices to accept.
Negotiate: Confidently negotiate with payers to ensure final population and bundled payment arrangements will lead to success.
Deliver: Easily track current and expected performance in any risk-based program, rapidly surface actionable insights on variation in care, identify highest-priority improvement opportunities (e.g., care network and model design), automatically calculate and distribute bonuses, and dynamically guide patients through personalized journeys of care.
Scale: Seamlessly manage across multiple reimbursement and risk arrangements, align physicians and partners, increase margins and re-invest in growth.

“The Clarify team is deploying novel approaches to aggregate and unlock the full potential of patient-level data,” said Niall Brennan, president of the Health Care Cost Institute (HCCI) and former chief data officer for CMS. “The team has developed an elegant solution to solving the problem of simultaneously managing multiple value-based payment models which has exciting, industry-wide applications for providers, payers, pharma, medical devices and government. Anyone seeking to optimize on delivering the Quadruple Aim should take note—and more importantly take action.”

About Clarify Health Solutions
We believe that together, we deliver better care. Clarify Health delivers the insights and digital solutions that empower physicians, health systems and payers to optimize care and thrive in a value-based world. The Clarify Health platform seamlessly integrates powerful analytics, artificial intelligence, real-time patient navigation and smart workflows to proactively guide patients and their caregivers through personalized care journeys. Providers and payers receive faster, more actionable insights to deliver optimal care. Clarify Health brings together committed and passionate colleagues with backgrounds in big data and AI engineering from financial services together with extensive clinical operations expertise. The team has a track record of achieving over $1 billion in improvement at more than 125 health systems, payers and pharmaceutical companies, and deploying cloud-based software at over 5,000 institutions.

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