What is eCareRevenue and who is it built for?

eCareRevenue is an AI platform for value-based care revenue and care-gap intelligence, surfacing gaps before the visit, lifting HCC/RAF accuracy, and forecasting performance. It's built for MSSP and REACH ACOs, Medicare Advantage plans, multi-specialty groups under risk, FQHC/RHC networks, and MSO/PE-backed and risk-bearing provider organizations.

How does eCareRevenue improve HCC capture and RAF accuracy?

It surfaces every suspected condition before and during the visit, so coding happens in the room instead of weeks later. Each suggestion is scored against CMS-HCC V28 logic and backed by MEAT chart evidence, which is how customers move RAF measurably in a single performance year.

Is the platform HIPAA-compliant and audit-defensible?

Yes. eCareRevenue is HIPAA-compliant and SOC 2 Type II, ISO 27001, and HITRUST certified, and we sign a BAA with every customer. Every coding suggestion links to MEAT chart evidence, so your RADV audit trail is built as you go, not reconstructed under pressure.

Does eCareRevenue connect to my EHR and claims data?

Yes, we connect to your existing EHR via SMART on FHIR and ingest 837/835 claims through your clearinghouse, with no rip-and-replace. Most customers are connected in 1-3 days and see gap detection running within the first week.

Will clinicians need a separate app?

No. Pre-visit prompts and gap insights appear inside the EHR your clinicians already use, there's no separate app to open, log into, or learn. The goal is fewer clicks at the point of care, not another tool competing for attention.

How does revenue forecasting and scenario modeling work?

eCareRevenue projects RAF, Stars, and shared-savings performance from your live data, then lets you model scenarios like closing a specific set of gaps and see the revenue impact instantly. It replaces the spreadsheet-and-wait-two-weeks approach with answers you can act on the same day.

How long does implementation take?

Most customers go live in 4-6 weeks across four steps: connect (1-3 days), calibrate your RAF baseline, pilot with a clinician group, then full rollout. EHR and claims ingestion is included, so there's no separate integration project to budget for.

eCareRevenue | AI Platform for Value-Based Care Revenue

Capture Revenue You’re Currently Missing

Help care teams uncover missed opportunities, strengthen risk adjustment accuracy, and improve reimbursement with AI-driven healthcare analytics built for value-based care.

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MSSP ACO · 240 clinicians

We were leaving HCCs on the table because our coders were chasing charts after the fact. eCareRevenue flags every suspected condition before the visit, so we capture it in the room. RAF: 0.94 to 1.21 in one year. Shared savings: $4.2M.

Dr. James Whitfield, MD

CMO · Cascade Health Partners ACO, Portland, OR

+0.27 RAF lift +$4.2M shared savings 68% of gaps closed pre-visit

Cascade Health Partners ACO

The Challenge

40% of recapture lost to after-the-visit chasing
RAF 18% under the cohort benchmark
No defensible binder if RADV came knocking

The Result

Gaps surfaced pre-visit
RAF lifted to 1.21 with MEAT evidence
$4.2M shared savings + RADV audit binder

+0.27

RAF Lift

+$4.2M

Shared Savings

68%

Of Gaps Closed Pre-Visit

Medicare Advantage · 4 H-contracts

Our consultant said 18 months to 4 stars. eCareRevenue’s cut-point projections got us there in 11. The Stars bonus paid for the platform nine times over.

Patricia Vega

VP, Quality & Stars · Coastal Health Plan, Miami, FL

3.5 → 4.0 stars 11 mos target hit 9x platform ROI

Coastal Health Plan (H1234)

The Challenge

3.5 stars, QBP bonus lost
HEDIS gaps 6 weeks stale
No cut-point distance per measure

The Result

Cut-point projections targeted the right measures
Daily gap lists fed the call center
4 stars in 11 months, QBP restored

3.5 → 4.0

Stars Rating

11 mos

Target Hit

Platform ROI

Multi-Specialty Group · 88 clinicians

Our consultant said 18 months to 4 stars. eCareRevenue’s cut-point projections got us there in 11. The Stars bonus paid for the platform nine times over.