Empowering Accurate Coding, Quality Care, and Shared-Savings Success

As Medicare Advantage (MA) grows—now covering more than 33 million beneficiaries in 2024 (CMS)—payers and providers face increasing pressure to close coding and care gaps, improve quality scores, and protect revenue in risk-sharing arrangements.

That’s where Health Data Max (HDM) helps providers thrive.

Why Providers Choose HDM

🔹 End-to-End Risk Adjustment

Streamline HCC coding with AI-powered chart review and clinical validation.
Ensure complete and compliant diagnosis capture for accurate RAF scoring.
Strengthen RADV and audit readiness with built-in traceability and CMS-aligned workflows.
Ensure accurate RAF scoring and prevent revenue leakage.

🔹 HEDIS & Quality Performance

Track Star Ratings and HEDIS metrics in real time.
Identify care gaps across preventive screenings, chronic conditions, and follow-up measures.
Equip providers with actionable insights to improve outcomes and performance bonuses.

🔹 Advanced Analytics + NLP

Combine structured claims with unstructured clinical data (notes, discharge summaries, labs).
Use Natural Language Processing (NLP) to surface missed diagnoses and coding opportunities.
Gain a 360° view of each member’s health status.

🔹 Proactive High-Risk Patient Management

Flag rising-risk and high-utilization members early.
Optimize care management programs to reduce avoidable admissions.
Improve population health while meeting CMS quality thresholds.

The HDM Advantage

Accuracy + Compliance → Ensure CMS submissions are clean, timely, and audit-ready.
Better Care, Better Scores → Improve HEDIS/Stars performance with AI-backed insights.
Revenue Protection → Capture every valid HCC to optimize risk scores.
Transparency → Dashboards give payers full visibility into provider and program performance.

With HDM, providers gain a trusted partner that combines advanced analytics, NLP, and CMS-compliant workflows—helping you deliver better care while strengthening financial results

It’s your data. Let’s make it work harder.