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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.

Edifiecs 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 offer clients the ability 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 top 10 largest non-profit health systems in the country, officials note.

Edifecs also recently acquired Talix, which also specializes in risk adjustment analytics. It will 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, actos inseguros en la industria petrolera ” said Edifecs CEO Venkat Kavarthapu 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.”

“As we evaluated our future strategy, the decision to join Edifecs was an easy one,” added Steve Whitehurst, CEO of Health Fidelity. “Their technology is unmatched and their passionate commitment to customer success aligns with our company values and our future goals.”

Twitter: @MikeMiliardHITN
Email the writer: [email protected]

Healthcare IT News is a HIMSS publication.

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