PAYERONE

Drive Value-Based Care at Scale

Eliminate critical barriers to provider adoption and unlock the full potential of value-based care

Upgrade from basic quality and risk tools and gain a true data strategy partner

Harness the full power of your data, drive superior outcomes, and stay ahead of regulatory changes. We help you identify gaps, optimize member care and maximize financial performance, all while ensuring compliance and boosting your STAR ratings.

PayerOne Highlights

PayerOne Highlights

Explore the key quality and risk features designed to help Health Plans deliver exceptional performance

All-in-one Solution

Integrate all data sources to enable payer and provider collaboration across quality and risk

NCQA-Certified

Leverage a NCQA-certified vendor for timely, accurate and secure HEDIS® submissions

Point of Care Integration

Engage providers and drive quality and risk initiatives at the point of care to close care gaps

Real-time Dashboards

Utilize actionable dashboards to engage providers and drive behavior change in care teams

Population Health Analytics

Unlock powerful and actionable population health analytics for both quality and risk

Health Equity Insights

Discover and act on health equity opportunity insights across all populations and initiatives

Customer Relationship Management (CRM)

Gain visibility, coordinate and manage care with members across organizations with global CRM views

Accurate Risk Adjustment

Use AI and analytics to improve member care while aligning risk adjustment revenue with disease burden

V28 Transition Support

Streamline transition to an advanced ML suspect model with layered clinical rules

Powered by Cozeva, a secure cloud-platform designed to drive provider engagement and organizational performance

Unified Experience

Exchange bi-directional data and merge views across tenancies to establish a unified experience across your POs, practices, providers and care teams

Artificial Intelligence

Analyze billions of data points using AI to predict member engagement, identify complex patients, stratify risk, prevent high-cost events, measure ROI and more

Advanced Analytics

Leverage AI and predictive analytics to deep dive into cost, utilization, quality and risk performance, and disparities across 200+ preconfigured analytic workbooks

EHR Integration

Seamlessly integrate with desktop and web-based EHRs to surface care gaps in provider workflows for closure, accurate coding and collection of clinical data

360 Patient View

Gain insights into member needs, preferences and behaviors by bringing together data from multiple sources – claims, EHRs, SDoH, engagement and more

Population Health

Identify opportunities, drive end-to-end performance improvement workflows and coordinate care with an intuitive and flexible interface designed for diverse teams

Real-time Gap Closure

Take action and mark gaps as pending, enter supplemental data and confirm or disconfirm HCCs within clinical workflows to drive provider engagement and build trust

Care Team Well-Being

Leverage AI, automation and pre-built tools and templates to up-level your teams, reduce admin burden, and improve provider and care team well-being

And more

While these are our more commonly talked about features, there's more to explore — experience the full potential of our platform by scheduling a demo!

Demonstrated success from coast to coast