Medicaid plans operate under intense oversight, unique state-based requirements, and tight margins. These are the issues Medicaid leaders raise with us most, and they’re exactly what Pareto solutions are built to solve.
Risk adjustment that prioritizes the high acuity members, improves point-of-care documentation, and ensures accurate encounter submissions
Payment integrity that improves claims payment accuracy as the payer of last resort
Member engagement for hard-to-reach, high-need populations across multiple channels
Operational efficiency amid evolving state requirements and data handoffs
Outcome-first solutions, designed for Medicaid realities and delivered with compliance-first execution.
with pre- and post-pay analytics that navigate the complexities of Medicare Secondary Payor (MSP) coordination.
by uncovering diagnosis gaps, engaging the highest need members, improving point-of-care documentation, and achieving complete and accurate encounter submissions.
with targeted, personalized outreach with incentives tied to plan goals (e.g., preventive care, chronic condition management, appointment adherence).
Pareto brings Medicaid-aware analytics and turnkey execution together so plans can move from identifying issues to fixing them, fast. We design compliance-first programs, align to state and CMS expectations, and measure what matters.
On June 28th, 2019, the Centers for Medicare and Medicaid Services (“CMS”) released the Affordable Care Act (“ACA”) Risk Adjustment Transfer Payment results for the 2018 benefit year. Within days
For Medicaid MCOs, Pareto focuses on encounter data quality, payment integrity, targeted engagement for high-need populations, and capitation accuracy—with solutions powered by the ParetoIQ platform for predictive insights and transparent reporting.
Pareto Intelligence is a healthcare analytics and technology company that helps improve risk, quality, compliance, and financial performance. Our platform spans payment integrity, risk analytics, member engagement, and premium reconciliation—delivering audit-ready insights and measurable outcomes.
Fill out the form to take the first step toward reaching your goals. Share a few details so we can provide the right resources and support tailored just for you.
Fill out the form to take the first step toward reaching your goals. Share a few details so we can provide the right resources and support tailored just for you.
Fill out the form to take the first step toward reaching your goals. Share a few details so we can provide the right resources and support tailored just for you.
