Financial Stability. Complete Reconciliation. Validated Risk.
ACA Market Place
A smarter ACA risk adjustment strategy starts here.
ACA
Overview
The Affordable Care Act (ACA) presents health plans with a uniquely challenging environment: high member churn, limited retrospective visibility, and tight margins in a zero-sum risk adjustment program. Most plans struggle to track risk accurately across years and lines of business—especially when prior data comes from Medicaid or Commercial sources.
Invent Health’s ACA solution delivers end-to-end visibility, actuarial-grade accuracy, and seamless EDGE submission alignment, helping health plans maximize their net transfer payments while improving preventive care engagement.
Whether you’re dealing with fragmented claims, bundled encounters, or limited suspecting capabilities, our platform brings order, automation, and intelligence to the ACA risk adjustment process.
Highlights
Key Capabilities
Gaps from Date-of-Service Overlap Resolution
Real-Time Dashboards & Risk Score Tracking
Invent Health for ACA Risk Adjustment
Affordable Care Act
Specific Differentiators
- Built-in EDGE QA checks and submission validation
- AI/NLP-enabled first-pass coding accuracy
- Flexible chase strategies (provider fax, EMR, in-home)
- Scalable suspecting algorithms tuned for ACA dynamics
- Integration-ready for actuarial & finance teams
Contact us
Ready to Transform Your ACA Risk Adjustment Performance?
Schedule a demo and see how Invent Health transforms your ACA Risk Adjustment performance.
Our Blog
Healthcare Insights,
Made Simple
Explore expert perspectives on risk adjustment, AI-powered analytics, and healthcare innovation. Stay informed with actionable insights designed for health plans, providers, and managed care organizations.
The Silent RADV Killer
The worst time to discover organizational silos is when the RADV audit notice arrives. The best time to break them down is now. Successful health…
Provider Engagement in Risk Adjustment
Standing in a busy provider’s office, documentation reports in hand—every risk adjustment professional knows that moment. The real challenge in provider engagement isn’t technology or…
The New RADV Reality
Health plans face multiple, simultaneous RADV audits—proactive resource planning and audit readiness are now essential for Medicare Advantage and ACA compliance success.
