Pareto’s Revenue & Payment Integrity solutions ensure you capture complete, accurate, and compliant revenue in all regulated markets. Our 40+ health plan and risk-bearing provider clients rely on Pareto’s proven process and advanced analytics to evaluate and improve revenue management through risk documentation improvement, data integrity evaluations, premium reconciliation, payment integrity and coordination of benefits (COB), and quality improvement efforts.
We take a holistic approach to revenue to improve financial performance.
Pareto’s Applied Analytics solutions harmonize disparate third party, health plan, and clinical datasets, and apply market-leading analytic models to inform strategic product, pricing, and market decisions. We analyze current membership, expected financial performance, utilization, and more to pinpoint and prioritize key areas to improve short- and long-term performance, and gain a competitive advantage in the market.
These analytics solutions are complemented by expert advisory support to understand unique situations and uncover tailored opportunities for improvement.
Pareto’s Healthcare Data Integration solution efficiently ingests, standardizes, and enriches disparate health plan and clinical data sources to create a comprehensive patient view (including claims, clinical, and social determinants of health) that drives downstream analytics and applications. This solution empowers our clients to process data at scale, navigate constantly changing file schemas, layouts, and time constraints, and apply clinical ontologies, Natural Language Processing (NLP), and other models to translate clinical data into actionable insights.
We help address the data challenges facing healthcare organizations today while establishing the data architecture required to succeed long term.
Pareto Engage evolves how critical patient information is communicated with providers to improve decision making and patient outcomes. This intelligent communication platform delivers patient-specific insights directly into EHRs and clinical workflows to solve for the asymmetry of information between health plans and providers. We meet providers where they are through flexible connectivity and delivery (e.g., Direct, APIs, FHIR) to maximize adoption and achieve risk, quality, and clinical objectives.
Pareto Engage is most powerful when combined with our other solutions to activate data and improve value-based outcomes.
Our Data Management Platform
Pareto’s Data Management Platform, the foundation to our solutions, is built around data lake and open source big data technologies to allow us to effectively ingest data in all formats and types at scale, organize them with appropriate data governance mechanisms within our data catalog, and provide efficient configuration capabilities to democratize data access and analytics.