Data Analytics Platform
The Caredatum Platform
Real-time operational intelligence for risk adjustment, quality performance, utilization management, and population health.
Core Capabilities
Risk Adjustment & HCC
Identify RAF gaps worth $13M+ annually, with realistic recoverable opportunity in the $4–7M range after natural recapture at routine visits. Surface suspecting diagnoses, track recapture rates, prioritize by revenue impact.
Quality & HEDIS Tracking
Roughly 20K open HEDIS care gaps prioritized for currently-active members. Star Ratings monitoring, AWV scheduling, prioritized worklists for care coordinators. Never miss a quality metric that impacts your ratings and bonus revenue.
Financial Intelligence
Capitation variance analysis that surfaced $700K+/yr in missed payments. Enrollment gap tracking, rate discrepancy detection, automated reconciliation. Get paid what you're owed, every month.
Real-Time ED Alerts
15-minute notifications from 700+ Florida hospitals via HIE integration. Know when members hit the ED before the claim is filed. Rapid intervention reduces costs and improves outcomes.
Transition of Care Revenue
TCM billing at $201–$273 per episode. Track discharges, coordinate follow-ups, capture revenue automatically. Transform discharge events into billable care coordination episodes.
Member 360 View
Complete member context across all payers. Diagnoses, prescriptions, care gaps, risk scores, utilization history — unified in one view. Care teams work smarter with full visibility.
Proven Results
Real Numbers from Real Operations
Case Study
Real Results from Day One
A Florida MSO managing 30,000+ active members across 10+ payer contracts partnered with Caredatum. Within weeks, they had visibility they'd never had before.
$13.7M HCC revenue identified at risk ($4–7M realistically recoverable)
$700K+/yr Capitation underpayments surfaced through variance analysis
~20,000 Open HEDIS care gaps prioritized for currently-active members
700+ Hospitals connected for real-time ED alerts via HIE notifications
4 weeks From contract to live portal
"For the first time, we can see across all of our payer contracts in one place. The capitation variance analysis alone paid for the entire engagement within the first month."
Chief Operations Officer
Florida MSO — 30K+ active members
See It in Action
Request a walkthrough of the Caredatum analytics platform with your own data.
Or email us at [email protected]