Risk adjustment solution for health plans
Accurate risk adjustment is critical to health plans’ ability to serve—and be properly compensated for—the healthcare needs of their member populations. But an array of obstacles stands in the way—many of them beyond health plans’ direct reach. By enabling health plans and PCPs to work together more effectively, the Vatica Health risk adjustment solution helps them drive more effective risk adjustment—and fully reap its benefits.
The challenges of risk adjustment
Risk adjustment can be adversely affected by many factors, including data inaccuracy and incompleteness, provider documentation and coding issues, changing regulatory requirements, fraud, inadequate member engagement and more. This can have a negative impact on everything from population health management efforts and financial modeling to regulatory compliance and premium rate-setting.
Vatica Connect
With Vatica Connect, PCPs can complete risk adjustment workflows directly within their existing Electronic Medical Record (EMR) system—no additional logins, no switching screens and no extra hassle.
Benefits of Vatica Connect include:
- Concise and actionable alerts delivered to PCPs in the EMR when they have a Vatica-supported visit
- Immediate access within the EMR patient record to the list of possible conditions contextualized by the clinical evidence curated by Vatica Clinical Consultants
- Intuitive coding and documentation exercise that can be completed quickly, during or after the patient visit
Recognition
Named Best in KLAS®
three years in a row
2025 marked the third year in a row that we were recognized with the Best in KLAS distinction in the Risk Adjustment Software and Professional Services category.
What makes Vatica different?
PCPs get the support they need
Vatica Health delivers expertise directly to resource-constrained PCPs, helping them supply health plans with more accurate and complete diagnosis coding and documentation and improve patient engagement.
Advanced technology drives efficiency and accuracy
Vatica Health software makes coding easier and more accurate, easing the burden on both providers and health plans. Accuracy and specificity are improved by 12% or more.
More comprehensive data provides a more complete picture
Vatica Health synthesizes EMR (via EMR access) and health plan data to create the most comprehensive and complete view of each member. This process drives a higher gap closure rate while supporting compliance, improving predictive modeling, driving population health management efforts and increasing member satisfaction.
Hear from our customers
“We’ve advocated that one of our other large payers in the community partner with Vatica so we can use the solution for more of our patients. We’d like to see all the payers in our marketplace use Vatica and look forward to leveraging Vatica as we transition to more value-based care. Our group is very appreciative of Vatica’s efforts, partnership and collaboration.”
General Physician PC, New York
“I find the process to be very easy, and we get valuable information. Vatica collects data from different providers and presents it to us in one place—it’s a one-stop shop.”
Nuestra Clinic, Texas
“For our practice, the first ‘toe in the water’ toward transitioning to value-based care was our contract with Vatica. There was a concerted effort in our organization to make sure that some of the savings that comes from this work is shared with physicians. Physicians were motivated to change. They’re doing a better job of assessing risk, understanding where the higher risk population is and directing services toward that population.”
NEMG, Connecticut
“I’ve been most impressed with Vatica’s ‘at-the-elbow’ customer service. It’s been such an easy process for our clinicians to onboard. The team is willing to come out—even on short notice—to make sure that the clinicians can log on and use the product with a real case. When they’re done, the clinicians have a good understanding of how to use the product to its fullest extent.”
UC Health, Ohio
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