An evolved prospective risk capture program is essential for MAOs to improve overall revenue accuracy. Read our key takeaways on how to pivot from existing retrospective programs.
Achieve more complete, accurate, and compliant risk scores with the Pareto Hub: the single data environment and source needed to run all aspects of your risk adjustment program. The Hub eliminates black-box analytics and empowers your revenue team with unparalleled data access and transparency.
Complete Risk Documentation
Increase revenue and limit compliance exposure through our Premium Integrity Solution. We assist organizations in identifying and recovering mistaken premium payments, helping clients receive an average 5:1 return on investment.
Identify and Recover Premium Payments
Maximize the recovery of overpaid claims, uncover underpaid claims, and reduce future mistaken payments with our Payment Integrity Solution. Our data solutions give health plans a comprehensive view into improving their overall payment process.
Ensure Claims Payment Accuracy
Innovative Tech Unlike Any Other
We combine our deep understanding of the unique and complex challenges facing healthcare organizations with market-leading technology solutions–all built to rapidly and effectively make sense of healthcare data.
average for MA
and ACA clients
impact for underreported risk
and medical costs
Give Us Your Challenges.
We'll Give You Solutions
90% of Pareto clients are returning clients. See why our powerful platform is reshaping how healthcare organizations use data.
Expert Advisory At Every Step
Grow and transform your organization with industry-leading consulting from our advisors. We support payers at every decision-making level to enhance strategic planning and improve revenue outcomes.Learn about our advisory services
KLAS Rated and Reviewed:
Top Performer for Risk Adjustment Solutions
"Pareto Intelligence offers consulting with their software, and that has been a really good fit for our organization. The other risk adjustment analytics solutions we looked at were more like software with a little consulting. The team we have is great, and they are doing the heavy lifting of a lot of the data work but are engaged with us on the interpretation as well." — KLAS Customer Review
INSIGHTS INSPIRING ACTION
In this interview with AIS Health, explore the ways in which tech-focused Medicare Advantage startups are planning for expansion, while new startup insurers declare their intentions in advance of the 2021 AEP.
Pareto received 6 awards across several company- and product-level categories and was one of only 17 entrants to win more than 5 awards.
Analyze the results of 2019 ACA risk adjustment transfer payments by issuer and state through an interactive dashboard.
What is the impact of increased telehealth flexibility due to COVID-19 on risk adjustment? Explore this analysis to uncover invaluable insights for healthcare organizations.
In a COVID-19 landscape, can predictive analytics and social determinants of health help you better care for your population? Pareto answers this question using data.
Taking proactive measures to improve risk documentation accuracy prevents RADV exposure, or worse, potential litigation. What should health plans do?
In this interview with AIS Health, hear strategies for incorporating lessons learned from 2020 into benefit designs before bids are due for 2021.
Pareto Intelligence is part of the Convey family of companies, which also includes Convey Health Solutions, GHG Advisors, and HealthSmart International. Together, we collectively support healthcare organizations with elite consulting services and industry-leading technology solutions.