Analytics company Edifecs announced Monday that it has finalized its acquisition of Health Fidelity, which specializes in risk-adjustment software for payers and providers.
WHY IT MATTERS
The deal, first announced in November, will bring Health Fidelity’s analytics tools, developed to help risk-bearing organizations gain insights into care planning and enable more complete revenue capture, into Edifecs’ portfolio.
Edifecs says it will offer customers more seamless natural language processing-based workflow and submissions tools with expanded suspecting and financial analytics technologies.
THE LARGER TREND
Health Fidelity’s tools are designed to enable clients to take risk adjustment beyond retrospective review, allowing for insights higher up in the clinical workflow – offering the ability to help customers more prospectively assess risk through pre-submission and post-encounter reviews. The company now serves six of the 10 largest provider-sponsored plans and four of the 10 largest non-profit health systems in the country, officials note.
Edifecs, which recently acquired another risk-adjustment analytics company, Talix, plans to integrate both companies’ technologies into its Encounter Management product to help customers manage Medicare Advantage, Managed Medicaid and Affordable Care Act reimbursement products.
ON THE RECORD
“Traditional risk-adjustment solutions have rapidly outgrown their retrospective-only payer use cases,” Edifecs CEO Venkat Kavarthapu, said in a statement. “By combining Health Fidelity and Talix solutions with our own workflow, Edifecs can now offer payers and providers clinical and coding solutions that deliver risk-adjustment insights across many operational areas, all while enabling the shift to value-based care.”
Steve Whitehurst, CEO of Health Fidelity, said, “As we evaluated our future strategy, the decision to join Edifecs was an easy one. Their technology is unmatched, and their passionate commitment to customer success aligns with our company values and our future goals.”
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