Acquisition of Health Fidelity Completed by Edifecs

Edifecs, a data analytics firm, stated on Monday that it had completed the acquisition of Health Fidelity, a provider of risk adjustment software for payers and providers. Health Fidelity’s analytics solutions, created to help risk-bearing enterprises acquire insights into care planning and enable more complete revenue capture, will be added to Edifecs‘ portfolio as part of the purchase, which was first announced in November.

Customers will be able to use more seamless natural language processing-based workflow and submission capabilities, as well as expanded suspecting and financial analytics technology, according to Edifecs. Health Fidelity’s technologies enable clients to go beyond retrospective risk assessment, allowing for insights earlier in the clinical workflow — allowing customers to more prospectively analyse risk through pre-submission and post-encounter reviews.

Officials say the company currently services six of the top ten largest provider-sponsored plans in the country, as well as four of the top ten largest non-profit health systems. Talix, a company that specialises in risk adjustment analytics, was recently acquired by Edifecs. It will include the technologies of both companies into its Encounter Management package to assist customers in managing Medicare Advantage, Managed Medicaid, and Affordable Care Act payment programmes.

Traditional risk adjustment systems have quickly outgrown their initial use cases that are only retroactive. Edifecs can now offer payers and providers clinical and coding solutions that deliver risk adjustment insights across various operational areas while facilitating the shift to value-based care by merging Health Fidelity and Talix technologies with our own workflow. Steve Whitehurst, CEO of Health Fidelity, said, “Their technology is unmatched and their passionate commitment to customer success aligns with our company values and our future goals.”