How it works
Start with the data you already receive
We analyze the same Medicare claims files your ACO already gets through CCLF or BCDA.
Most engagements start with a simple export - no new integrations or IT work required.
Detect abnormal provider behavior
Our models analyze utilization, coding, and cost patterns across your provider network. We flag providers whose billing behavior is statistically outside their peers in the same specialty, region, or care setting. We value precision above all other metrics, and adamantly believe our role is to assist with care, not prevent it. Our models will only flag providers with the utmost certainty of abnormal behavior.
Rank the highest-impact opportunities
Instead of manual SQL scans or retrospective reviews, we generate prioritized reports showing:
- Providers driving abnormal spend
- Services with excessive or unusual utilization
- Estimated dollars at risk
This helps compliance and clinical teams focus on the cases most likely to affect shared savings.
Take action earlier in the performance year
By identifying abnormal patterns months sooner, ACOs can:
- Intervene with providers
- Adjust care pathways
- Reduce avoidable spend before reconciliation