The Platform

The platform to optimally manage your entire Medicare population.

We work to maintain consistency in the approach to patient care and documentation across Original Medicare, Medicare Advantage and dual eligible populations, delivering the highest value at an appropriate cost. In other words, High Value Care.

Original Medicare

Fee-for-service beneficiaries, including those attributed to an ACO.

Medicare Advantage

Plan-enrolled beneficiaries, where documented disease burden sets the payment.

Dual Eligible

Covered by both Medicare and Medicaid. The most complex patients in any panel.

High Value Care

What that actually means.

Four things, applied the same way to every population we manage. None of them are program-specific, because good care is not program-specific — only the paperwork is.

01

Maximize objective metrics associated with quality of care.

We track the measures CMS and health plans actually score, and report them by population, practice and physician — while there is still time to act on them.

02

Deploy statistically proven interventions.

Interventions with evidence behind them, aimed at three outcomes: fewer avoidable adverse events, better quality of life, lower mortality.

03

Ensure appropriate and audit-defensible documentation.

Disease burden and overall risk only count if the record supports them. We make sure it does, and that it holds up to audit.

04

Risk-stratify your populations.

An average tells you nothing about who needs help. We sort your population by risk so your team knows who to reach first.

Changing the Outcome

We intervene early to move cost down and quality up.

Cost and quality are distributions, not averages. The earlier we act on a patient, the further both move.

Move the curve yourself

Total cost of care

$8,400$11,100$13,800$16,500$19,200
View the underlying numbers
Illustrative model. Share of the population at each cost level, with and without Medicare Platform getting involved at step 1 of 12.
Total cost of careBaselineWith the platform
$8,4000.0%0.6%
$9,3000.3%3.7%
$10,2001.6%10.9%
$11,1005.4%19.5%
$12,00012.1%23.7%
$12,90019.3%20.4%
$13,80022.6%12.8%
$14,70019.3%5.9%
$15,60012.1%2.0%
$16,5005.4%0.5%
$17,4001.6%0.1%
$18,3000.3%0.0%
$19,2000.0%0.0%

Illustrative model, not results. Values are hypothetical and do not represent any Medicare Platform population.

If we get involved at step 1 of 12 in a patient’s care, the modelled average cost moves from $13,800 to $12,180 (-11.7%), and the share of patients in the high-cost group moves from 7.3% to 0.6%.

Lines of Work

One platform, three ways in.

The same infrastructure and the same standard of care, applied wherever you are accountable for a Medicare population.

-- ACO Support --

The operations layer under an MSSP ACO.

Physician-level analytics, alignment monitoring, care management, CMS reporting, and transparent shared-savings distributions.

-- Risk Adjustment --

Documentation that reflects the patient in front of you.

Suspect identification on a 14-year lookback rather than the standard three, recapture strategy, and HCC gap tracking that stays current.

-- RADV Audit & Compliance --

Find the exposure before an auditor does.

Chart validation against claims, MEAT and ICD-10 review, and audit simulation.

About Us

One platform, one standard of care.

Medicare pays for the same patients through different programs, each with its own rules. Most practices end up running a different playbook for each one.

We collapse that into one: the same approach to care and to documentation across every population, so quality is measured the same way everywhere.

Get in Touch

Let's talk about your population.

Tell us who you are accountable for and we'll walk through what managing it on one platform looks like — no obligation.

(949) 220-1820·Fax (949) 220-1920·[email protected]

Schedule a call

We'll respond within one business day with available times.

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