Health plans are required to report member diagnoses, which are used to “risk-adjust” premiums from government sponsors to the health plan based on the health status of members. The traditional methods for risk adjustment and clinical quality (retrospective chart reviews and in-home assessments) have limited impact on outcomes and can also increase compliance risk. Recognizing these shortcomings, Vatica Health pioneered a provider-centric approach to risk adjustment and clinical quality that pairs expert clinical teams with cutting-edge technology to work with providers at the point of care. Vatica’s approach produces better and more compliant results for health plans, providers, and patients, as highlighted by the company’s 2020 results.
Vatica’s rapid growth, despite the extraordinary challenges arising from the COVID-19 pandemic, underscores the need for solutions that improve quality of care and optimize revenue. In 2020, Vatica expanded its provider network by over 30% and increased encounter volume by nearly 40%.
“We are thrilled to support our thousands of providers with initiatives that improve both clinical and financial performance, especially during these trying times,” said CEO of Vatica Health, Dr. Hassan Rifaat.
Vatica’s growth in physician participation is driven by its continued expansion of health plan partnerships. In 2020, Vatica drove significant market expansions into 12 new states: Arkansas, Illinois, Kansas, Michigan, Minnesota, Missouri, Montana, Nebraska, Ohio, Oklahoma, Texas, and Wisconsin. To support the new physicians and health plans working with Vatica, the company grew its employee headcount by over 30%.
“The healthcare industry is experiencing a perfect storm in which primary care physicians are struggling. They lack the resources and tools to thrive in value-based care arrangements, patients are skipping routine and preventive care, which are critical to mitigating the impact of chronic conditions, and health plans are coming under increasing pressure regarding coding and documentation compliance from government audits and various lawsuits. We are fortunate to have developed an innovative solution that elegantly addresses all of these problems,” Dr. Rifaat continued.
As Vatica celebrates its tenth anniversary later this year, the company is aggressively investing in new markets to meet health plan and provider demand. With nearly a 200% increase in patients eligible to participate in Vatica’s program, Vatica anticipates another year of significant growth and expansion in 2021.
About Vatica Health
Founded in 2011, Vatica Health is the leading provider-centric risk adjustment and quality of care solution for health plans and health systems. By pairing expert clinical teams with cutting-edge, HITRUST-certified technology at the point of care, Vatica increases patient engagement and wellness, improves coding accuracy and completeness, identifies and closes gaps in care, and enhances communication and collaboration between providers and health plans. The company’s unique solution helps providers, health plans, and patients achieve better outcomes, together. Vatica Health is trusted by many of the leading health plans and thousands of providers nationwide. Vatica Health is a portfolio company of Great Hill Partners. For more information, visit https://www.vaticahealth.com/.