Our end-to-end solutions help 19 of the top 20 payers run their core operations and scale complex, value-based payment models across providers' networks. The portfolio includes solutions that enable payers to ensure accurate payments and optimize their provider networks, and analytics that help them adopt value-based payment models.
Network & Financial Management
Risk Adjustment, Quality, and Engagement
Our analytics and related services help ensure health plans are successful in addressing the complex reimbursement and compliance challenges of government-sponsored plans. Today, 9 of the top 10 Medicare Advantage plans rely on Change Healthcare for analytics-driven solutions for member engagement, risk adjustment, and quality performance.
Clinical Decision Support
Our evidence-based clinical criteria help payers and providers make clinically appropriate utilization decisions–a key component of the medical review, authorization, and care coordination processes. Today, 3,700 hospitals and more than 250 health plans trust InterQual to deliver medical guidelines to the point of care, enabling them to drive down inappropriate care, and reduce fraud and waste.
Revenue Cycle Management
Our end-to-end suite of workflow and analytics solutions automate reimbursement and simplify patient collections for hospitals, physician offices, laboratories, and other ancillary care providers. We automate and streamline reimbursement for 2,400 hospitals and 80,000 providers, with solutions spanning the revenue cycle from patient access and claims management to AI-powered analytics, complemented with revenue optimization services.
Our diagnostic imaging solutions help increase productivity, optimize performance, and enable collaboration for radiologists and cardiologists in 3,300 facilities in the U.S., U.K., Ireland, and Canada. Change Healthcare is leading the industry transformation from departmental to enterprise-wide solutions, while driving out costs and unlocking data for better outcomes.