Step 1 Data Integration & Normalization

Kairon Data Platform aggregates MSSP and MA contract data – harmonizing across claims, EHR, payer information, and ^{HCC scoring details}.

Metric governance ensures data accuracy and enables apples-to-apples comparisons.

Step 2 Comprehensive Performance Analysis

Kairon Insights provides side-by-side and year-over-year performance views – adjusting for claims completion, practice portfolio shifts, and ^{changes in the HCC risk adjustment model}.

AI-driven predictive analytics forecasts performance trajectory and ^{identifies practice/provider billing pattern deviations}.

Step 3 Prioritized Action Plans

Kairon Engage generates prioritized opportunity lists, spotlighting practices and providers ^{with the greatest potential to impact recapture efforts}.

The system automates workflow recommendations, focusing on high-impact, actionable initiatives for optimal results.

Step 4 Facilitating Forward Momentum

Kairon Manage tracks field team efforts, assessing engagement with practices and ensuring resources are invested where needed.

Example: MSSP ACO Improving HCC Recapture

• ACO leadership gains real-time visibility into which practices are performing better vs. worse year-over-year.
• Kairon detects billing pattern anomalies, surfacing that a subset of practices have never billing more than 4 diagnosis codes.
• Targeted recommendations guide practices to resolve practice management system bugs, bolstering more accurate risk adjustment.