Risk adjustment solution for providers
Vatica Health risk
adjustment solution
Risk adjustment is essential for documenting the severity and complexity of patient conditions. By accurately capturing active conditions with the greatest degree of specificity, health plans and PCPs are:
- Appropriately compensated for necessary care
- Properly incentivized to focus on preventive care and the management of chronic conditions
- Ensured the resources needed so that patients can access the comprehensive medical benefits they need
By enabling PCPs and health plans to work together more effectively, the Vatica Health risk adjustment solution helps them improve clinical performance. These improvements ultimately benefit patients by enabling their access to affordable, high-quality care.
The challenges of risk adjustment
Risk adjustment is a proven method for aligning capitated provider payments based on each patient’s characteristics and health conditions. However, accurate risk adjustment can be a challenge due to factors such as coding and documentation complexity, time constraints, a lack of training, poor data integration and patient engagement issues. This can have a negative impact on clinical performance and the patient experience.
Risk adjustment benefits for patients
Better quality of care
Accurate risk adjustment helps close care gaps and provides a complete picture of each patient’s health status, thereby helping to ensure that more patients receive the right interventions and treatment.
Assured funding for care
Risk adjustment ensures that the appropriate funding is available for health plans to cover the cost of care and for PCPs to execute care plans.
Lower costs
Accurate risk adjustment coding aligns payments with the expected cost of care and focuses healthcare organizations on managing high-cost patients with multiple chronic conditions, which helps improve efficiency and reduce unnecessary costs.
Care for those who need it most
Risk adjustment discourages health plans from not enrolling patients with complex medical needs.
Vatica Connect
With Vatica Connect, you can complete risk adjustment workflows directly within your existing Electronic Medical Record (EMR) system—no additional logins, no switching screens and no extra hassle.
The application is currently available for our Epic, athenahealth and eClinicalWorks clients. Support for additional EMRs is planned.
Vatica Connect includes:
- 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
- Automatic transmission of accepted diagnosis codes to the EMR after PCPs complete and sign their Vatica visits and attachment of the Vatica medical record document to the EMR visit record.
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?
Expert clinical staff support
Vatica Health provides Clinical Consultants who train and support provider teams and ensure proper coding and documentation and data sharing. This support benefits both health plans and PCPs.
Prompt and lasting results
Because the Vatica solution is intuitive and adapted to PCPs’ daily needs and workflows, clinical staff can learn how to use it quickly and integrate it into their daily work. This, in turn, means more accurate and comprehensive patient information and more efficient operations for PCPs.
Proven performance
The Vatica Health risk adjustment solution is proven to improve coding, help PCPs close care gaps, increase support for chronic conditions, double patient penetration, and increase accuracy and specificity by 12%.
An enhanced PCP experience
Vatica is committed to consistently improving the provider experience. Our physician advisory board, composed of active Vatica clients, meets routinely to provide feedback and insights.
Hear from our customers
“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
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Adjust your approach to risk adjustment
Talk to one of our risk adjustment experts today to see how we can help you deliver better performance and stronger compliance while closing gaps in care.