Value-based care
Let the care team
do the caring.
Your team is short of hours, not judgement. IASORA does the gap-chasing, coding and outreach on your own record, and stops at a clinician before anything is filed.
TEAM · CJR · MSSP / ACO · EOM · KCC
A care gap on a report costs you money. The contract pays only for one closed and verified.
The work itself
Six levers, each run by an agent.
Risk adjustment and HCC capture
A monthly sweep surfaces suspected conditions, substantiates them against the record and queries the provider where evidence is thin.
Quality gaps and measure reporting
Preventive, screening and chronic gaps detected against evidence-based rules, closed and verified. HEDIS and MIPS cohorts use the same engine, so the measure matches the work.
Care coordination
A daily sweep of open tasks, care plans and care teams. Every item has an owner and a due date, and escalates if the loop stays open.
Clinical documentation integrity
Notes read for specificity and gaps, with provider queries raised on the condition rather than in a month-end audit.
Cost and utilisation
Avoidable spend and utilisation outliers across the attributed panel, sized by setting.
Medication and pharmacy coordination
Adherence check-ins on the care plan, and pharmacy coordination on every new or changed prescription, so a therapy change does not fail between visit and fill.
The models, running
Five payment models. One execution engine.
Each film follows one episode or performance year through the product, on the screens your team would use.
Transforming Episode Accountability Model
Hospital accountable · surgery through 30 days after discharge · mandatory from 2026
Five surgical categories, a 30-day window from discharge, and a hospital carrying the cost of everything in it, including care delivered elsewhere. The episode is won or lost in the handoffs.
The film follows one patient across eight beats, from pre-operative risk through each handoff to episode performance.
47 seconds. The handoff across settings is beat five.
Comprehensive Care for Joint Replacement
Hospital accountable · 90-day lower-extremity joint replacement episode
The same problem as TEAM over a longer window: the episode runs from admission to 90 days after discharge, so the cheapest work happens before surgery. An HbA1c above threshold, pre-operative anaemia, an INR of 3.8, no confirmed support at home: this is the cheapest point to change the cost.
Later, post-acute destination and late readmission dominate the spend, so beat five sits at day 45 rather than day 9.
42 seconds. Opens at pre-operative optimisation.
Medicare Shared Savings Program
Accountable entity · total cost of care across a performance year · quarters, not days
Eight beats of a performance year, from attribution to reconciliation, following the ACO quarter by quarter rather than a patient.
It ends on PMPM against benchmark, shared savings and the quality gates that decide whether you keep them. One gate is failing, 34.6% avoidable ED against a 30% target, and we left it failing because the data says so.
47 seconds. Every screen is live data from our demo workspace, nothing injected.
Enhancing Oncology Model
The oncology practice is accountable · six-month episodes from initiation of systemic therapy
Here the oncology practice carries the risk, with the model's own trigger, measures and penalised utilisation.
The film opens on the model's eligible population, then follows one patient: 86, lung carcinoma, on carboplatin and pemetrexed, in the ED with febrile neutropenia on day 75. The practice carries that visit, and the ePRO reporting severe fatigue between cycles was the signal that could have prevented it.
Seven beats. The accountable entity is the practice.
Kidney Care Choices
The nephrology practice is accountable · CKD stage 4 to 5 and ESRD
The economics turn on one decision made months before it shows in a claim. In the first year, a planned home dialysis start costs roughly $76,000, a planned start on a matured fistula about $88,000, and an unplanned inpatient start on a central venous catheter about $109,000.
The difference is a vascular access referral placed while eGFR is still falling, which is a workflow problem. The film sits in that window: eGFR down from 29.9 to 25 over fifteen months, with no access plan.
Six beats. The money is made before the start.
Being precise about the films
What is computed, and what we need from you.
The films are recorded in our demo workspace, not a customer's. The patients are real records that pre-date every model shown; programmes, contracts and performance panels are read live from the product.
Computed today, from data you already hold
- Risk stratification and rising-risk ranking, every weight and threshold visible
- Care gap detection, ownership, escalation and verified closure
- Outreach on SMS, WhatsApp and AI voice, tracked to closure
- Episodes built from an anchor admission and a configurable window
- Cost by setting: anchor stay, post-acute, readmission, professional, ED, pharmacy
- A risk-adjusted benchmark price from a trimmed mean of your past episodes
- Quality gates, PMPM trend, avoidable utilisation and the shared savings position
The one integration ask
- Under TEAM and MSSP, CMS sets the target price and reconciles against it. Ours is a benchmark from your own history, and every surface labels it so.
- To reconcile against the real number, we ingest your CCLF claims files into the same engine. That is the only integration this depends on.
- Where claims coverage is thin, the engine falls back to an encounter proxy and labels the metric as a proxy.
How this is different
Your analytics vendor stops where this starts.
| Population health analytics | IASORA |
|---|---|
| Ranks the population by acuity | Ranks by how much risk is still movable |
| Produces a care gap list | Turns each gap into owned, escalating work |
| Reports outreach as sent | Tracks every loop to closure or escalation |
| Refreshes overnight from a warehouse | Reacts to the live clinical event stream |
| Hands the worklist to your care managers | Agents do the work behind a human approval gate |
| Tells you the contract position after the quarter | Reconciles continuously, gates and all |
| Sits beside the EMR as another screen | Writes finished work back into the record |
Who this is for
Four people sign off. Each needs a different answer.
In health systems, IDNs, physician groups, ACOs, IPAs and the management services organisations behind them. All four see the same number.
VP, Value-Based Care
The contract position, continuously
- PMPM against benchmark, live
- Quality gates with the failing ones visible
- Shared savings modelled at your share
- Which interventions moved the number
Chief Medical Officer
A score you can defend
- Every weight and threshold visible
- Clinical rules escalate, not a black box
- Human approval gate on every agent action
- Full audit trail on each decision
Care Management
Capacity spent where it counts
- A ranked worklist
- Outreach that runs itself between calls
- Escalation when a loop does not close
- One board across settings
Chief Financial Officer
Where the cost actually is
- Spend by setting inside every episode
- Avoidable utilisation, sized
- Leakage and network performance
What it runs on
The same record the rest of the platform writes to.
Population Health
Care gap detection, cohorts and the loop from gap to verified outcome.
Explore Population Health →Risk Stratification
Transparent scores, updated continuously, every contribution visible.
Explore Risk Stratification →Automation & Insights
The agents that do the work, behind your approval gate.
Explore Automation →Prove it on your own population
A four-to-six-week pilot on your data and your contract, ending on a number you can take to the board. The fee credits toward the agreement.
Get started
Bring your contract. We will run it against your data.
A working session on the model you are accountable for.