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 $12M+ annually. Surface suspecting diagnoses, track recapture rates, prioritize by revenue impact. Automated HCC opportunity identification ensures you're capturing every dollar available to your organization.

Quality & HEDIS Tracking

35K+ HEDIS care gaps tracked across all payers. 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 found $600K+/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

$12M+
HCC Revenue Identified
35K+
Care Gaps Tracked
$600K+
Underpayments Found/Year
<15 min
Alert Response Time

Case Study

Real Results from Day One

A South Florida MSO managing 80,000+ members across 10+ payer contracts partnered with Caredatum. Within weeks, they had visibility they'd never had before.

$12M+ HCC revenue at risk identified

$600K+/yr Capitation underpayments found

35,000+ HEDIS care gaps tracked across 25K+ members

700+ Hospitals connected for real-time ED alerts

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."

CO

Chief Operations Officer

South Florida MSO — 80K+ members

See It in Action

Request a walkthrough of the Caredatum analytics platform with your own data.

Or email us at [email protected]