Actionable Analytics. Impactful Interventions. Comprehensive Coding.
Medicare Advantage
Unlock RAF accuracy, optimize chart reviews, and drive member outcomes across your MA population.
Medicare Advantage
Overview
With over 33 million Medicare Advantage enrollees in 2024, accurate risk adjustment has never been more mission-critical. Yet, AWV completion rates remain below 35%, and in-home assessment (IHA) engagement is often under 25%—leaving significant coding gaps, care gaps, and revenue leakage.
Invent Health’s MAO solution enables health plans to close HCC coding gaps, improve submission integrity, and drive proactive interventions at scale. Our platform integrates NLP-powered chart review, AI-based suspecting, and real-time RAF analytics—ensuring that every opportunity to improve outcomes and capture risk is surfaced and acted upon.
Highlights
Key Capabilities
Invent Health MAO Advantage
Use Case Snapshot
Medicaid Advantage
Plan Profile
- Lives Covered: 250,000 MA; 60,000 DSNP
- Models Supported: CMS-HCC, ESRD, RxHCC
- Chart Reviews/Year: 50,000
- IHA + AWV Participation: 62% aggregate
Results
- Coding Accuracy: Up 95% with NLP + coder QA
- Unreconciled HCCs: Down from 22% to 8%
- RAF Lift: 8–10% improvement
- AWV Participation: Up from 45% to 58%
- IHA Engagement: Up from 5% to 14%
Contact us
Turn Risk Adjustment Into
A Strategic Advantage
Enabling accurate risk adjustment, seamless provider collaboration, and proactive care strategies to help health plans drive better outcomes and financial 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.
