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Los Angeles Times
16 hours ago
- Business
- Los Angeles Times
New Report on State of Technology in Value-Based Care Exposes Tech and Data Barriers
Glendale-based Reveleer, a leading value-based care technology platform, in partnership with Mathematica, a policy data and analytics company, has released the '2025 State of Technology in Value-Based Care Report.' The report comes during a pivotal moment in healthcare transformation. While payer and provider alignment around value-based care (VBC) has never been stronger, execution is falling behind. The report reveals that while there is widespread confidence in technology's potential to support value-based care, significant barriers such as fragmented data strategies, uneven AI adoption and insufficient staff training are hindering progress and scalability. The report findings defy a common industry narrative that payers and providers are misaligned on priorities. In fact, 100% of providers and 97% of payers surveyed agree their value-based care goals are strongly aligned. What's missing is synchronized execution. Despite shared vision, payers and providers are operating in parallel rather than in concert, pointing to an inefficiency that limits the impact of technology investments and makes scale more difficult. Meanwhile, momentum continues to build: 92% of payers and 81% of providers surveyed saw their VBC contracts grow in the past 12 months. And even more expect growth ahead, with 94% of payers and 83% of providers forecasting increases in the next 12 months. But if execution continues to lag behind ambition, progress may stall before it can transform care. 'To realize the full potential of value-based care, payers and providers must collaborate at scale,' said Jay Ackerman, CEO of Reveleer. 'The good news is payers and providers are finally rowing in the same direction. But if they don't row in sync, we won't move forward. This report points to a clear call to action. The alignment is there, and the tools are ready. Tighter collaboration and true transformation are within reach.' Data management is viewed as a strategic asset by virtually every organization surveyed. 97% of providers and 96% of payers agree that a strong data management approach gives them a competitive edge in the marketplace. Yet behind that confidence lies significant operational fragmentation. Only a third of surveyed providers (33%) and payers (31%) rate their data integration capabilities as 'excellent.' Yet only about half (46% of providers and 53% of payers) are very confident in the accuracy and completeness of the patient data they use in VBC initiatives. This gap between perception and precision signals a major vulnerability in scaling VBC effectively and safely. Every payer and provider surveyed reports using AI. And most agree it's delivering results: 96% of both payers and providers agree their approach to AI adoption and implementation has given them a competitive advantage, and more than 80% of each report seeing positive impacts, including: But enthusiasm hasn't translated into full commitment. Only 40% of payers and 38% of providers say they are fully committed to AI adoption. Just 21% of payers and 29% of providers report a significant increase in AI use in the past 12 months. Underlying this hesitation are concerns about AI hallucinations, algorithmic transparency and the ethics of AI-assisted decisions without human oversight. These concerns don't negate AI's value, but they do signal the need for more robust frameworks for responsible adoption. Despite confidence in AI's promise, organizations are underinvesting in the people who need to use it. While all organizations surveyed offer at least some AI training, only 30% of payers and 32% of provider organizations offer extensive training programs. This lack of preparation is a likely contributor to AI hesitancy and a barrier to scaling its use. As the pressure to improve outcomes and reduce costs intensifies, organizations that pair technology with workforce readiness will be better positioned to lead. 'Technology is a powerful enabler, but it's not a magic wand,' said Ngan MacDonald, director of data innovations at Mathematica. 'The path to scalable value-based care demands more than alignment. It demands real investment in data infrastructure, workforce readiness and AI governance. This report highlights where the friction lies and where leaders need to focus next.' Information sourced from Reveleer. To learn more, contact srubin@
Los Angeles Times
29-04-2025
- Business
- Los Angeles Times
Reveleer Acquires Novillus to Expand Its AI-Powered Clinical Intelligence and Quality Solutions
Acquisition Strengthens Provider Engagement, Care Gap Management, and Compliance Solutions to Improve Health Outcomes and Financial Performance Glendale-based Reveleer, a value-based care technology platform, has announced the acquisition of Novillus, a provider of insight-driven care gap management and frictionless provider engagement solutions. This acquisition further augments Reveleer's clinical intelligence and quality improvement solutions in value-based care, aiming to empower health plans and providers to collaborate more effectively to improve patient outcomes, strengthen regulatory compliance and bolster financial performance. As the importance of Medicare Advantage Star Rating intensifies and the healthcare industry increasingly emphasizes stronger alignment between payers and providers to succeed in value-based care, the acquisition positions Reveleer to further empower its customers to adapt and excel in a shifting value-based care environment. Novillus' technology will accelerate Reveleer's strategy of delivering modern, easy-to-use solutions that enable seamless collaboration between payers and providers for risk adjustment, quality improvement and other patient improvement efforts. This includes the ability to pinpoint care gaps and performance trends at the provider group level to improve their education. 'By acquiring Novillus, we're accelerating our strategy of aligning payers and providers to improve health outcomes through faster care gap closure,' said Jay Ackerman, CEO of Reveleer. 'This acquisition strengthens our platform's ability to deliver unmatched AI-powered quality and clinical intelligence solutions while helping our customers not only meet but exceed their goals for Star Rating performance, risk adjustment accuracy and care gap closure. All are key areas that drive improved patient outcomes, reduce cost of care and improve financial success.' Novillus' technologies will extend Reveleer's ability to bring payers and providers together through enhanced AI automation, real-time roster management and advanced provider engagement workflows. Its Clean Provider Data solution strengthens regulatory compliance by supporting consistent adherence to the federal No Surprises Act and other regulations, reducing risk, improving directory accuracy, enhancing patient satisfaction and minimizing provider abrasion. 'Our shared vision is to revolutionize how health plans and providers use data to drive better outcomes,' said Jerry Hagan, CEO of Novillus. 'By joining Reveleer, we can accelerate our mission to improve provider engagement, close care gaps and maximize regulatory compliance at scale. This is a win for our customers, their patients and the broader value-based care ecosystem.' The combined company will serve 72 million covered lives and work with 86 leading healthcare organizations across the U.S., further establishing Reveleer as the go-to solution for health plans and providers navigating the complexities of value-based care. 'Over the past three years, Reveleer has taken a strategic approach to broadening its offerings and building out one of the most comprehensive value-based care platforms on the market,' said Andrew Adams, co-founder and managing partner at Oak HC/FT. 'With the acquisition of Novillus, Reveleer's expanded offerings in care gap closure and provider data stand to deliver even more value to health plans, providers and patients.' Information was sourced from PR Newswire. To learn more, contact info@
Associated Press
05-03-2025
- Business
- Associated Press
Reveleer Launches Next Generation Risk Solution for Unparalleled Accuracy, Efficiency, and Financial Performance
New AI-driven technology transforms retrospective risk adjustment with real-time insights enhancing coding precision and automated workflows GLENDALE, Calif., March 5, 2025 /PRNewswire/ -- Reveleer, the leading value-based care enablement platform, today announced the launch of its next generation retrospective risk technology, designed to advance risk adjustment programs with unparalleled accuracy, efficiency, and compliance. As payers and providers navigate increasingly complex regulatory environments, accurate risk adjustment has never been more critical. Reveleer's advanced technology ensures precise Medical Record Review (MRR) while improving operational and financial impact without compromising compliance. By harnessing the power of AI with EVE (Reveleer's Evidence Validation Engine), Reveleer now leads the market through its predictive clinical insights with up to 99% accuracy, advanced dynamic clinical validation, and intelligent automation that reduces coding duration by up to 42.5%. Combined with a modern user experience, Reveleer is transforming retrospective risk with remarkable accuracy, productivity and financial performance for its customers. 'Our platform is built for those seeking to modernize their risk adjustment programs with artificial intelligence assisted workflows,' said Paul Burke, Chief Product Officer at Reveleer. 'By leveraging our proprietary technology and intelligent automation, we provide our customers with the opportunity to increase their efficiency and productivity while improving their RAF accuracy and HCC capture.' Key benefits of Reveleer's AI-powered next-generation retrospective risk technology: AI-Powered clinical review: Clinical insights with up to 99% accuracy, minimizing coding errors and improving RAF capture. Dynamic HCC validation: Real-time hierarchical dynamic validation improves efficiency without compromising compliance or increasing audit risk. Seamless collaboration tools: Real-time audit log, annotations, and in-app messaging improve workflow efficiency and coordination. Enhanced member view: Comprehensive health profiles enable better clinical insights and accurate coding decisions. Optimized user experience: Dual-screen support, bulk actions, and dark mode enhance productivity and ease the cognitive burden for users. Powerful Platform: In 2024, we processed 1.1 billion pages of medical charts, and delivered 2.5 million diagnoses. 'Retrospective risk adjustment is critical for financial sustainability in value-based care, yet current technologies and manual processes are fragmented, time-consuming and prone to errors,' said Jay Ackerman, CEO of Reveleer. 'Our next generation risk solution is just the beginning of how Reveleer intends to lead the market into the next evolution of value-based care. The pressure of a changing value-based care ecosystem on our customers is only increasing, and so must our investment in innovation.' Reveleer will be exhibiting at RISE National, March 11 – 13, 2025 in San Antonio, TX where it will be showcasing this next generation risk solution, along with its quality and clinical intelligence solutions. To learn more about Reveleer, our platform, and solutions, visit About Reveleer As the industry's pioneering value-based care (VBC) enablement platform, Reveleer is purpose-built to solve the most pressing real-world challenges faced by providers and health-plan organizations today. By unifying retrieval, clinical intelligence, risk adjustment, quality improvement, and member management solutions into one intelligent, AI-powered system, Reveleer streamlines fragmented workflows to supercharge productivity, enhance care quality, and optimize performance on high-priority value-based initiatives. To learn more about Reveleer's value-based care platform, visit us at
