UPMC Selects Health Fidelity’s NLP-Powered Solution for Payer – Provider Collaboration

Internationally Recognized Health System Selects HF360 Provider Solution to Optimize Accurate Risk Capture in Physician Workflow

Health Fidelity, Inc., a company that develops innovative technologies for the value-based care era, today announced that UPMC had selected HF360 Provider, the industry’s first NLP-powered, EHR-integrated physician workflow solution for risk and quality gap closure. UPMC, a leading integrated healthcare delivery and finance system, partners with and is an investor in Health Fidelity.

HF360 Provider is an end-to-end solution that combines analytics, technology, services, and subject matter expertise to help provider organizations succeed in value-based care programs. Unlike other solutions, HF360 Provider addresses the specific needs of providers and integrates into existing EHR workflows. The solution organizes risk capture activities into pre-, during- and post-patient encounter workflows with the requisite tools and strategies for each phase.

UPMC is using HF360 Provider to standardize the risk capture process across all populations and increase the efficiency of that process through targeted patient interventions. This will allow UPMC to capture the risk across populations without significant change to physician workflow or physician engagement, while simultaneously reducing operational costs and timeframes.

“Developing an accurate portrayal of our patient population’s disease burden is a key organizational goal for our health system. We were looking for tools to standardize risk capture across our patient population and do so without burdening our physicians and clinical staff, “ said Fran Solano, M.D., president, Community Medicine Inc. at UPMC.  “Given the complexity of the various value-driven models we participate in, we needed a population-agnostic methodology to understand and baseline the inherent patient risk in order to inform our population health and care management strategies. Health Fidelity’s HF360 Provider suite helps us to achieve those goals.”

According to Health Fidelity CEO, Steve Whitehurst, UPMC’s unwavering commitment to clinical excellence is evident in its ability to embrace innovation. “The combination of an integrated delivery system and health plan working together to improve the coordination of care and lower the cost of membership without sacrificing quality is incredibly powerful,” he said. “We are proud that our NLP-driven workflow is equipping UPMC with the ability to find and optimize patient risk, in turn yielding shared savings that can fund the adoption of these holistic approaches across additional populations.”

HF360 Provider enables providers to:

  • Identify, capture, and document risk across Medicare Advantage, ACA, ACO, and Medicaid populations.
  • Collaborate with payer partners to optimize risk capture more effectively and efficiently.
  • Assist physicians with structured guidance during encounter documentation for timely, accurate risk capture within existing EHR workflows.

To learn more, visit HF360 Risk Adjustment for Risk-Bearing Providers.


About Health Fidelity

Health Fidelity delivers comprehensive, scalable risk adjustment solutions for risk-bearing entities that participate in Medicare Advantage, ACA, Medicaid, and Medicare ACO programs. With a combination of big data analytics and natural language processing (NLP) technology, Health Fidelity’s modern prospective and retrospective risk adjustment approaches extract valuable insights from medical charts, changing the way risk is identified, quantified, and managed for enhanced operational, clinical, and financial outcomes.

Health Fidelity is a registered trademark of Health Fidelity, Inc.

Health Fidelity simplifies risk adjustment, offering risk-bearing organizations clear visibility into and control over the process. Through our NLP-powered solutions and expert advisory services, we uncover insights that enable better care plans and more complete revenue capture. The Lumanent® suite gives our partners the confidence to pursue and ability to succeed in risk-sharing arrangements across MA, ACA, Medicaid, and ACO programs.


Andrea Serra
(650) 727-3300