Cotiviti
Cotiviti provides data-driven healthcare solutions that help you improve financial performance, enhance clinical outcomes, and ensure payment accuracy across your entire healthcare organization.
HealthEC
HealthEC is a population health management platform that integrates data from disparate sources to help you identify care gaps, manage risk, and improve patient outcomes across your entire network.
Quick Comparison
| Feature | Cotiviti | HealthEC |
|---|---|---|
| Website | cotiviti.com | healthec.com |
| Pricing Model | Custom | Custom |
| Starting Price | Custom Pricing | Custom Pricing |
| FREE Trial | ✘ No free trial | ✘ No free trial |
| Free Plan | ✘ No free plan | ✘ No free plan |
| Product Demo | ✓ Request demo here | ✓ Request demo here |
| Deployment | ||
| Integrations | ||
| Target Users | ||
| Target Industries | ||
| Customer Count | 0 | 0 |
| Founded Year | 1979 | 1997 |
| Headquarters | South Jordan, USA | Piscataway, USA |
Overview
Cotiviti
Cotiviti provides a comprehensive suite of data analytics and payment integrity solutions designed to help you navigate the complexities of healthcare reimbursement. You can use the platform to identify payment errors before they happen, manage risk adjustment programs, and analyze clinical performance data to improve patient outcomes. By processing billions of medical claims annually, the software gives you the insights needed to reduce waste and ensure every dollar spent on healthcare is used effectively.
The platform is specifically built for health insurance payers, providers, and government agencies who need to manage large-scale data sets. You can automate the auditing process, track quality metrics like HEDIS, and gain a clearer picture of your financial health through advanced predictive modeling. It helps you bridge the gap between clinical data and financial results, allowing your team to focus on delivering high-quality care while maintaining a sustainable bottom line.
HealthEC
HealthEC provides a comprehensive population health management solution designed to help you succeed in value-based care environments. By aggregating data from EHRs, claims, labs, and pharmacies into a single source of truth, the platform gives you a 360-degree view of your patient population. You can identify high-risk patients, track quality measures in real-time, and coordinate care across different providers to ensure no one falls through the cracks.
The platform is built for accountable care organizations (ACOs), clinically integrated networks, and large health systems looking to reduce costs while improving quality scores. You can use the built-in analytics to uncover social determinants of health and automate outreach to patients who need intervention. It simplifies complex reporting requirements and helps you maximize shared savings by closing care gaps efficiently.
Overview
Cotiviti Features
- Payment Integrity Identify and prevent inaccurate claims before payment to reduce medical spend and improve your bottom line.
- Risk Adjustment Capture accurate patient risk profiles using advanced analytics to ensure you receive appropriate reimbursement for care.
- Quality Intelligence Track and report HEDIS and other quality metrics automatically to improve your star ratings and clinical performance.
- Clinical Analytics Analyze patient data across different care settings to identify gaps in care and improve long-term health outcomes.
- Network Optimization Evaluate your provider network performance to ensure you are partnering with the most efficient and high-quality clinicians.
- Consumer Engagement Use data-driven insights to communicate with members and encourage healthier behaviors through personalized outreach.
HealthEC Features
- Universal Data Integration. Connect disparate data sources like EHRs, claims, and labs into one unified longitudinal record for every patient in your network.
- Predictive Risk Stratification. Identify high-risk and rising-risk patients using AI-driven algorithms so you can intervene before costly health events occur.
- Care Gap Analysis. Track clinical quality measures in real-time and receive automated alerts when patients are due for screenings or chronic care visits.
- Care Management Workflow. Coordinate care plans across multidisciplinary teams with shared tasks, notes, and automated workflows to improve patient adherence.
- Value-Based Analytics. Monitor your financial performance and quality benchmarks against contract goals to maximize your shared savings and incentive payments.
- Patient Engagement Tools. Communicate with your patients through secure portals and automated reminders to encourage self-management and reduce no-show rates.
Pricing Comparison
Cotiviti Pricing
HealthEC Pricing
Pros & Cons
Cotiviti
Pros
- Unmatched depth in healthcare-specific data analytics
- Significantly reduces manual effort in claims auditing
- Helps maintain compliance with complex government regulations
- Strong track record with large-scale health insurance payers
Cons
- Implementation process requires significant time and resources
- Interface can be complex for non-technical users
- Custom pricing is geared toward larger enterprises
HealthEC
Pros
- Excellent data aggregation from highly diverse EHR systems
- Comprehensive reporting for MIPS and ACO quality measures
- Strong focus on social determinants of health data
- Highly customizable dashboards for different clinical roles
Cons
- Initial data mapping requires significant implementation time
- Interface can feel complex for non-technical clinical staff
- Custom reporting often requires assistance from support teams