Value-based contracts put you at risk for outcomes you can't always control. Pamastay gives risk managers the visibility to quantify exposure, identify drivers, and take action before losses materialize.
You're accountable for financial performance, but often lack the data visibility to manage it proactively.
You find out about benchmark misses months after the performance period ends. CMS MSSP reconciliation happens well after you can intervene.
Your risk adjustment revenue depends on accurate HCC capture, but you don't know which gaps exist until CMS calculates your final RAF.
A few high-cost providers can blow your entire budget, but you don't have visibility into who's driving variance until year-end reconciliation.
Different payers, different benchmarks, different quality measures. No unified view of your total risk exposure and performance.
ED visits, inpatient admissions, specialty referrals—utilization trends that impact your costs are often invisible until they show up in claims data you receive months later.
OIG-prioritized RADV audits, payer recovery efforts, and compliance findings can wipe out shared savings you thought were secured.
Turn claims data into actionable financial intelligence for risk-bearing organizations.
See where you stand against CMS benchmarks, payer targets, and internal budgets—updated as claims flow in, not months after period close.
Projected risk scores based on current documentation, with gap analysis showing which HCCs are missing and their revenue impact.
See which providers are driving cost variance—by total spend, per-member, by service category. Identify outliers before they blow your budget.
Analyze payment patterns and payer-specific trends across your claims. Understand reimbursement variance, denial patterns, and payer behavior to inform contract negotiations.
Automated alerts when utilization patterns shift—ED visit spikes, inpatient admission trends, specialty referral increases—so you can intervene early.
Identify claims and HCCs most likely to be targeted in RADV or payer audits. Quantify your exposure and prioritize pre-audit remediation.
See how Pamastay turns claims data into financial intelligence for risk managers.