Value Based Care Intelligence
AI supporting value based care performance: risk prediction, care gap identification, panel prioritization, and total cost of care analytics. Several vendors in this category also bear risk or enable risk bearing arrangements; evaluation should separate the analytics platform from the risk vehicle, and weigh whether prediction claims are validated against realized utilization in published or peer reviewed form.
Vendors in this category
45 indexed
| Vendor | Category | AI Centrality | Website |
|---|---|---|---|
|
Z
ZeOmega
ZeOmega develops Jiva, a healthcare enterprise management platform for health plans and organizations managing population health and financial risk. Jiva brings together care management, quality…
|
Value Based Care Intelligence | B | zeomega.com |
|
S
SpectraMedix
SpectraMedix provides software for managing contracts and performance under value based payment arrangements. Health plans, health systems, and provider organizations use its platform for contract…
|
Value Based Care Intelligence | B | spectramedix.com |
|
P
Pelica
Pelica provides AI agents for health plans and provider organizations managing quality, financial risk, pharmacy adherence, and care coordination. The platform combines claims, clinical records,…
|
Value Based Care Intelligence | A | pelica.com |
|
H
Healthy
Healthy, formerly ClosedLoop, provides predictive analytics software for population health management. Health plans, accountable care organizations, and provider teams use its enterprise platform to…
|
Value Based Care Intelligence | A | gethealthy.com |
|
A
Arbital Health
Arbital Health combines actuarial services with software for managing financial performance under value based care contracts. Health plans, provider organizations, and care enablers use the platform…
|
Value Based Care Intelligence | B | arbitalhealth.com |
|
O
Onpoint Healthcare Partners
Onpoint Healthcare Partners sells the Iris Medical Agent AI platform, which pairs AI agents with a human review workforce to take over charting, coding and follow up work for medical groups and…
|
Ambient Scribes | B | onpointhealthcarepartners.com |
|
R
RadiantGraph
RadiantGraph sells proactive member engagement to health plans and health systems: it decides which members to contact, about what and through which channel, and then places the call itself. The…
|
Patient Voice Agents | B | radiantgraph.com |
|
C
Cedar Gate Technologies
Cedar Gate Technologies runs value based care arrangements end to end on one platform, from data management and analytics through to adjudicating the payment. Enterprise data management ingests more…
|
Value Based Care Intelligence | C | cedargate.com |
|
I
Inovalon
Inovalon is a data business that sells analytics and software on top of its data. Its real world data draws closed claims from more than 160 national, regional and local health plans, open claims…
|
Value Based Care Intelligence | C | inovalon.com |
|
L
Lightbeam Health Solutions
Lightbeam Health Solutions assembles a value based care operating system largely by acquisition, and the pieces it bought explain what it is. The core platform aggregates data from many sources,…
|
Value Based Care Intelligence | C | lightbeamhealth.com |
|
P
Persivia
Persivia sells health systems, accountable care organizations, physician groups and health plans a single platform for running value based contracts, and it is open about building that platform on a…
|
Value Based Care Intelligence | C | persivia.com |
|
H
Health Catalyst
Health Catalyst sells health systems the data layer beneath their improvement work, plus the people to run it. Its filings describe two segments: technology, covering a cloud data platform, analytics…
|
Health System AI Platforms | C | healthcatalyst.com |
|
A
Arcadia
Arcadia sells the data foundation underneath value based care, and increasingly the models that run on top of it. The platform ingests clinical records from more than fifty record systems, payer…
|
Value Based Care Intelligence | C | arcadia.io |
|
A
Astrata
Astrata reads clinical charts so quality teams do not have to. The company builds natural language processing for healthcare quality measurement, aimed at the HEDIS reporting that determines health…
|
Value Based Care Intelligence | B | astrata.co |
|
C
Clarify Health
Clarify Health now describes itself as a healthcare outcomes company that partners with health systems, a change from how it sold until recently. Two offers sit on one data layer. Clarify Meridian is…
|
Value Based Care Intelligence | B | clarifyhealth.com |
|
N
NeuroFlow
Behavioral health integration infrastructure sold to risk bearing organizations, health systems and health plans rather than to patients. Founded 2016 in Philadelphia by Chris Molaro, chief…
|
Behavioral Health AI | B | neuroflow.com |
|
A
AccuCode AI
AccuCode AI, founded in 2023 in Little Rock, Arkansas, with a second office in Seattle, runs autonomous medical coding and clinical quality abstraction on one engineering stack. The coding product…
|
Autonomous Medical Coding | A | accucodeai.com |
|
X
XpertDox
Autonomous medical coding through the XpertCoding product, paired with a business intelligence platform reporting coding accuracy, billing levels and provider performance, with dashboards for risk…
|
Autonomous Medical Coding | A | xpertdox.com |
|
M
mPulse
mPulse reaches health plan members at very large scale and uses models to decide which members to reach. Based in Los Angeles, backed by PSG and previously trading as mPulse Mobile, it describes…
|
Value Based Care Intelligence | B | mpulse.com |
|
R
RxAnte
RxAnte predicts which health plan members will stop taking their medication, and then sells the plan a way to intervene. It is a portfolio company of UPMC Enterprises, the venture arm of the health…
|
Medication Safety & Prescribing | B | rxante.com |
|
H
HiLabs
HiLabs, founded in 2014 by chief executive Amit Garg and Neel Butala and based in Bethesda, Maryland, with offices in Pune and Bangalore, sells AI that cleans and reconciles health plan data. Its…
|
Healthcare Administrative Automation | B | hilabs.com |
|
A
ActiumHealth
ActiumHealth is the healthcare patient communication product of Syllable, which acquired it in March 2024 and runs it as a division. It began in 2017 as SymphonyRM, a predictive outreach company, and…
|
Patient Voice Agents | A | actiumhealth.com |
|
A
Authenticx
Authenticx, founded in Indianapolis in 2018 by former healthcare executive Amy Brown, analyses the conversations healthcare organizations have with patients, members and professionals across…
|
Healthcare Administrative Automation | B | authenticx.com |
|
A
Attune
Attune, based in Chicago, launched publicly in January 2026 under chief executive Matt Coughlin and sells an agentic engagement platform for healthcare: Agentic Voice, a conversational voice agent…
|
Patient Voice Agents | B | attune.ai |
|
L
Laguna Health
Laguna Health, founded in 2020 by Yoni Shtein and Yael Adam and based in New York, applies conversational AI to the calls care managers hold with members. Its roots are in contextual care after a…
|
Value Based Care Intelligence | A | lagunahealth.com |
|
P
Popai Health
Popai Health, founded in 2024 by chief executive Eyal Gurion, chief product officer Michael Latar and chief technology officer Elad Levy and based in New York and Tel Aviv, builds what it calls…
|
Value Based Care Intelligence | A | popai.health |
|
O
Oatmeal Health
Oatmeal Health, founded in May 2022 by Jonathan Govette and based in San Jose, runs lung cancer screening programs for federally qualified health centers and the imaging centers and hospitals that…
|
Value Based Care Intelligence | B | oatmealhealth.com |
|
C
Carna Health
Carna Health is a Boston company founded in 2021 by Dr Salvatore Viscomi that builds screening and care management infrastructure for chronic kidney disease and the wider cardio kidney metabolic…
|
Value Based Care Intelligence | D | carna.health |
|
A
Arine
Arine sells medication intelligence to health plans rather than to hospitals. The platform ingests clinical, socioeconomic and behavioral data across a plan's membership, identifies members at risk…
|
Medication Safety & Prescribing | A | arine.io |
|
F
FeelBetter
FeelBetter applies machine learning to polypharmacy, the problem of an older patient accumulating enough medications that the regimen itself becomes the hazard. The platform synthesizes longitudinal…
|
Medication Safety & Prescribing | A | feelbetter.healthcare |
|
C
Credo Health
Credo Health, based in Denver and led by founder and chief executive Carm Huntress, retrieves and assembles patient records for value based care. Its Acquire agent identifies where a patient has…
|
Clinical Summarization & Chart Review | B | credohealth.com |
|
K
Kennar Health
Kennar Health, operated by Toothpicker Holdings, Inc. of Hicksville, New York, sells what it calls an AI workforce for value-based care. A scribe listens to the patient interaction and structures…
|
Value Based Care Intelligence | A | kennarhealth.com |
|
Z
Zus Health
Zus Health assembles a longitudinal patient record from national data networks and delivers it to care teams, analysts and developers. The Zus Aggregated Profile queries CommonWell and Carequality…
|
Healthcare Administrative Automation | C | zushealth.com |
|
A
Anterior
Anterior sells clinical AI to health plans and to the organizations that run clinical review for them. Its system, Florence, is built on frontier models and reads charts, faxes, structured feeds and…
|
RCM & Prior Auth AI | A | anterior.com |
|
N
Neurotrack
Neurotrack describes itself as a cognitive care enablement platform: digital cognitive assessments, an adaptive layer it calls Smart Logic, and care planning support, sold to help providers assess,…
|
Clinical Decision Support | D | neurotrack.com |
|
R
Reveleer
Reveleer is a Glendale, California company founded in 2009 as a medical record retrieval business and since rebuilt as a value based care platform for health plans and risk bearing providers across…
|
Value Based Care Intelligence | B | reveleer.com |
|
R
RAAPID
RAAPID is a Louisville, Kentucky risk adjustment company whose platform is built on what it calls neuro symbolic AI: machine learning combined with a clinical knowledge graph that links every…
|
Value Based Care Intelligence | B | raapidinc.com |
|
N
Navina
Clinician copilot that ingests data across the EHR, health information exchanges, insurance claims, and care gap files, then uses proprietary language models to classify documents and extract…
|
Clinical Decision Support | B | navina.ai |
|
G
Guidehealth
Guidehealth is a Dallas based operating platform for value based care and benefits administration, formed in 2023 and built partly on the acquired value based care services division of an analytics…
|
Value Based Care Intelligence | B | guidehealth.com |
|
T
Transcarent
Health benefits navigation and care platform for self insured employers, health plans and labor unions, indexed for its AI navigation layer with the surrounding care services as context. WayFinding…
|
Healthcare Administrative Automation | C | transcarent.com |
|
P
Particle Health
Particle Health sells access to patients' medical records through a single API. It queries CommonWell, Carequality, eHealth Exchange and state HIEs, with ADT feeds and pharmacy fill data, returning…
|
Healthcare Administrative Automation | C | particlehealth.com |
|
I
Innovaccer
Innovaccer, founded in 2014 and headquartered in San Francisco, sells what it calls an agentic cloud for healthcare: the Gravity platform, which unifies record system, claims, pharmacy, laboratory,…
|
Health System AI Platforms | B | innovaccer.com |
|
N
Notable
AI agent platform for health system and health plan operations. Agents work patient access (intake and registration, scheduling, referrals, order transcription, pre-procedure instructions by voice),…
|
Health System AI Platforms | B | notablehealth.com |
|
U
Upside
Upside (UpsideHOM, Inc.) is a housing stability service sold to Medicaid and Medicare Advantage health plans, health systems and employers, addressing housing instability as a driver of avoidable…
|
Value Based Care Intelligence | C | joinupside.com |
|
P
Pearl Health
Pearl Health is a New York value based care enablement company for Medicare primary care. Its platform analyses claims, ADT feeds and record system data to rank the patients who need attention first,…
|
Value Based Care Intelligence | B | pearlhealth.com |
Head to Head
Value Based Care Intelligence comparisons
14 published
Comparisons are published only where the index assesses two vendors as direct competitors for the same buyer. Each carries a verdict, the buyer conditions that favor each side, and a graded side by side across all fifteen capability axes.
ActiumHealth vs Attune→Arbital Health vs Cedar Gate Technologies→Arbital Health vs SpectraMedix→Arcadia vs Innovaccer→Authenticx vs Navina→Authenticx vs Popai Health→Cedar Gate Technologies vs SpectraMedix→Healthy vs Lightbeam Health Solutions→Laguna Health vs Popai Health→Navina vs RAAPID→Particle Health vs Zus Health→Pearl Health vs Reveleer→Pelica vs Reveleer→Transcarent vs Upside→