PopHealthCare (formerly PopHealthMan) has designed our solutions around a simple premise – help higher risk individuals live healthier lives. We believe that sophisticated analytics coupled with properly funded, compassionate clinical care can improve the health of populations, one person at a time. Our services include:

  • Administrative data review, financial forecasting & impact reporting
  • Sophisticated Predictive Analytics for retrospective & prospective risk adjustment, high risk population care and quality improvement
  • Integrated, comprehensive Risk Adjustment interventions and process management:
    • Retrospective chart targeting, retrieval, imaging, certified coding & HCC management
    • Prospective interventions (with physician support tools and In Home Assessments)
    • RAPS file creation, submissions and reconciliations
    • 5010 / Encounter Data Processing System (EDPS) support
    • Health Insurance Exchange data preparation and Edge Server services
  • High Risk Population Care:
    • Member identification, outreach and engagement
    • Comprehensive health, behavioral and risk assessments
    • Longitudinal care for complex behavioral and medical conditions including in-home medical care and supplemental telephonic support
    • Provider collaboration and coordination
    • Integrated risk adjustment and quality of care improvement

For more information:
Kevin Kenney
Chief Growth Officer
W: 615-721-7037