ACOs
Shared-savings tracking and quality reporting for accountable care organizations.
Value-Based Care
Value-Based Care Platforms
We build platforms that connect clinical outcomes to reimbursement — quality-measure tracking, risk-adjusted analytics, and contract dashboards that show, in near real time, where a value-based agreement stands against its targets.
HIPAA-ReadyFHIR R4HEDIS-AlignedAudit Logged
Trusted by global innovators
What value-based care software has to prove
Value-based care shifts payment from volume to results, which means the software has to do something fee-for-service systems never needed to: connect what happened clinically to what gets paid contractually. That requires ingesting claims and clinical data, attributing patients to programs, calculating quality measures, adjusting for risk, and projecting where a contract will land against its shared-savings or capitation targets.
Generic BI dashboards can chart a number, but they can't trace it back to the measure specification, the attributed population, and the contract term that make it meaningful. We build VBC platforms where every outcomes-to-reimbursement figure is auditable — you can drill from a shared-savings projection to the gaps, patients, and measures driving it, then act before the performance period closes.
What it is
Software that gets paid for results
A value-based care platform connects clinical outcomes to financial performance under risk-bearing contracts — computing quality measures, adjusting for population risk, attributing patients, and projecting earned reimbursement against contract targets.
Its job is to make performance visible early enough to act on. We build platforms where every outcomes-to-reimbursement number is traceable to its source, so care teams and finance can trust the same dashboard.
Outcomes-to-reimbursement, made visible
Quality measures, risk adjustment, and contract performance in dashboards that trace every number back to its source.
What we build into your VBC platform
Each capability ties a value-based outcome to the data standard or measure spec that makes it defensible.
Outcomes-to-reimbursement engine
A model that maps clinical and claims data to contract terms — shared savings, capitation, bundled payments — so you can project earned revenue against benchmarks throughout the performance period, not just at reconciliation.
Quality measure calculation
HEDIS, MIPS, and CMS Star measures computed from FHIR R4 clinical data and claims, with electronic clinical quality measure (eCQM) logic and gap-in-care detection that flags open measures while there's still time to close them.
Risk adjustment & HCC coding
HCC risk-score calculation and suspected-condition surfacing from clinical notes and claims, so risk-adjusted contracts reflect the true acuity of the attributed population.
Contract performance dashboards
Dashboards that show each value-based agreement against its targets — quality, cost, utilization — with drill-down from a top-line number to the patients and measures behind it and role-based views for executives and care teams.
Attribution & population panels
Patient-to-provider and patient-to-program attribution logic, with panel management views so care teams know exactly who they're accountable for under each contract.
Interoperable data foundation
A FHIR R4 data layer aggregating EHR, claims, ADT, and lab feeds via HL7 v2 and bulk FHIR $export, with encryption and audit logging so the analytics rest on governed, traceable data.
Where it runs
Value-based care use cases
Health plans
Contract performance and Star-rating management across networks.
Risk-bearing providers
Capitation and downside-risk monitoring for provider groups.
Clinically integrated networks
Cross-organization measure aggregation and attribution.
Medicare Advantage
HCC risk-adjustment accuracy and Star measure closure.
Employer & direct contracting
Outcomes reporting for direct-to-employer arrangements.
Where VBC software creates leverage
Value-based performance is won during the period, not at reconciliation. We build for visibility early enough to act — targets are defined against your contracts in discovery.
FHIR R4
Interoperable clinical data foundation
HEDIS
Quality measures computed to spec
HCC
Risk-adjusted outcomes-to-reimbursement
Compliance-First Healthcare App Development Services Backed by Global Standards
15-Minute Scoping Call01
HIPAA
Health Insurance Portability and Accountability Act
Protect PHI with privacy-first architecture, encrypted storage and transmission, strict access controls, and traceable audit logs.
02
GDPR
General Data Protection Regulation
Implement lawful consent flows, data minimization, retention controls, and secure processing for sensitive health data.
03
FHIR
Fast Healthcare Interoperability Resources
Enable standardized health data exchange across apps, care teams, and systems through robust FHIR-ready APIs.
04
HL7
Health Level Seven International
Support enterprise-grade interoperability with HL7-based integrations for records, events, and clinical messaging workflows.
05
HITRUST
Health Information Trust Alliance
Align security programs to healthcare-specific control and risk management practices trusted by providers and ecosystem partners.
06
HITECH
Health Information Technology for Economic and Clinical Health Act
Design with breach notification readiness, digital record safeguards, and operational controls that support regulated care programs.
07
SaMD
FDA Software as a Medical Device
Plan software quality, traceability, and documentation pathways for products that may require SaMD review and submission.
08
MDR (EU)
Medical Device Regulation (European Union)
Prepare EU market-ready processes for risk classification, evidence tracking, and lifecycle governance under MDR expectations.
09
SAMHSA
Substance Abuse and Mental Health Services Administration
Apply confidentiality controls and consent-aware sharing models for behavioral and mental health data experiences.
Standards we build against
Value-based care standards
FHIRHEDISeCQMHCCMIPSHIPAA
Our Process
How we deliver a VBC platform
Data aggregation, measure logic, and contract modeling run in parallel toward a defensible dashboard.
1.
Contract & measure discovery
We map your value-based agreements, the measures that drive them, and your available data sources, then design attribution and measure logic before building.
Contract-aware
2.
Data foundation
We build the FHIR R4 data layer aggregating EHR, claims, and ancillary feeds, with the governance and lineage the analytics depend on.
Traceable data
3.
Measures & reimbursement modeling
Quality-measure calculation, risk adjustment, and the outcomes-to-reimbursement engine, validated against known reconciliation results.
Defensible math
4.
Dashboards & go-live
Role-based contract dashboards with drill-down, gap-in-care worklists, and ongoing tuning as measure specs and contracts change year over year.
Always audit-ready
Featured case study
Read Case StudyLera Health: compliant women's health platform
Related proof of compliant delivery: Lera Health isn't a VBC platform, but building its outcomes-driven data layer and auditable insights workflow shows how we turn clinical data into trustworthy, traceable analytics — the foundation any value-based platform stands on.
Why Partner With Us
15-Minute Scoping CallWhy risk-bearing orgs pick Agnotic
We combine measure-spec fluency, data-engineering depth, and compliance-first design so your VBC numbers hold up in reconciliation and audit.
Defensible & Auditable
Every outcome and dollar traces back to its measure spec, attributed population, and source data — built to survive payer reconciliation.
Measure & Risk Fluency
HEDIS, MIPS, eCQM, and HCC logic are our baseline, so measure calculation is engineered correctly rather than approximated.
Act Before the Period Closes
Near-real-time gap and projection views so teams influence results while they still can, not after reconciliation.
Payer & Provider Perspective
We build for both sides of a value-based contract, aligning how outcomes are measured with how they get paid.
Our relevant experience
Analytics that hold up when the money is on the line
Frequently Asked Questions
Because the value is in correct measure and reimbursement logic, a real VBC build typically starts in the mid six figures. Scope drivers include the number of contracts, measure sets, data sources, and whether risk adjustment is included. We scope against your agreements in discovery.
Ready to see your contracts in real time?
Tell us your value-based agreements and data sources. We'll return a VBC platform plan with measure scope, risk-adjustment approach, and a realistic timeline.
contact@agnotic.com
Partnerships
contact@agnotic.com