Pulse8 Announces its Health Exchange Suite for Risk Adjustment

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John Criswell, Founder and CEO of Pulse8—a state-of-the-art analytics company focused on helping people live independent and healthy lives—announces Pulse8’s Health Exchange Suite.

John Criswell / CEO

Pulse8’s Health Exchange Suite products provide an unprecedented view into Risk Adjustment activities, behaviors, interventions, and data that give health plans the opportunity to quickly address risk adjustment factors, diagnosis trends, quality scores, and comparative performance metrics. Mr. Criswell explains; “Pulse8’s strategy allows us to quickly customize the approach by implementing complex algorithms, predictive models, and interventions for each plan and metal level, and to adapt to differing models implemented by each state”.

Mr. Criswell recognizes the unique characteristics of the Health Insurance Exchange Marketplace and the necessity to reach beyond claims data when applying predictive analytics and risk adjustment solutions. Pulse8’s unique use of medical and non-medical data sources significantly improve the accuracy of predictive models and other analytic tools, thus allowing a health plan to be competitive in the exchange marketplace.

HHS uses the concurrent risk adjustment model that compresses timelines proposed for the Health Insurance Exchange Marketplace making collecting accurate and meaningful data from providers a critical focus for health plans. Pulse8 offers unique data collection tools, including mobile applications that allow providers insight at the time of the encounter while providing health plans a direct data feed following a member’s visit.

Mr. Criswell emphasized the need for plans to directly engage their members. He stated, “The lack of patient data could cause loss of revenue, increased utilization, increased cost, and missed benefits. Closing this data gap early improves quality of care and enhances revenue opportunities:% Pulse8 is at the forefront of capturing member-provided data using mobile technology.

Pulse8 provides health plans with the ability to leverage and scale existing infrastructure and systems with independent and informed analytics, data collection tools, and integration systems connecting every component of the medical system from provider to patient.

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