Analysis firm Edifecs announced Monday that it has completed its acquisition of Health Fidelity, which specializes in risk adjustment software for payers and providers.

WHY IS IT IMPORTANT
The deal, first announced in November, will integrate Health Fidelity’s analytics tools, developed to help at-risk organizations better understand care planning, and enable more comprehensive revenue capture, across the portfolio. Edifecs.

Edifecs says it will offer more transparent natural language processing-based workflow and submission tools to clients with extensive suspicion and financial analysis technologies.

THE BIGGEST TREND
Health Fidelity’s tools provide clients with the ability to adjust risk beyond retrospective review, allowing insights to be gained higher in the clinical workflow – providing the opportunity to help clients assess risks more prospectively through pre-submission and post-meeting reviews. The company now serves six of the 10 largest provider-sponsored plans and four of the 10 largest nonprofit health systems in the country, officials note.

Edifecs also recently acquired Talix, which also specializes in risk adjustment analysis. It will integrate technologies from both companies into its Encounter Management product to help clients manage Medicare Advantage, Managed Medicaid and Affordable Care Act reimbursement products.

ON THE RECORD
“Traditional risk adjustment solutions have quickly overtaken their retrospective use cases only for payers,” Edifecs CEO Venkat Kavarthapu said 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 provide risk adjustment insights in many operational areas while enabling the shift to value-based care. “

“As we assessed 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 our customers’ success aligns with our company values ​​and our future goals. “