AI Native – Built for Today and Beyond

Intelligence that elevates care.

ElevateCare gives ACOs, IPAs, and health systems real-time roster accuracy, prospective RAF capture, and year-round HEDIS gap closure, with cohort analysis powered by ElevateIQ — the operational foundation that makes value-based care actually work.

PayorsHealth SystemsACOs & IPAsFQHCsIndependent Clinics

Intelligence Layer

ElevateIQ

Natural-language AI that turns your ElevateCare data into real-time answers, care plans, and opportunities — at patient, cohort, and population scale.

Proven Outcomes

ROI you can measure on day one.

15%

Revenue increase

Gap closure & coding compliance

25%

Workforce efficiency gain

Less time spent reconciling, more time on care

30%

Reporting burden reduction

Automated quality + value-based reports

15 min

Analytics turnaround

Down from 3 weeks of manual pulls

Roster Management

Know exactly who's on your panel. Right now.

Attribution lag costs ACOs 30–90 days of actionable data. ElevateCare reconciles payer feeds, EHR records, and claims in near real-time — so every care team always works from a verified, current roster.

  • Attribution lag: Rosters finalize 30–90 days after the period ends — care teams are managing a population that no longer exists.
  • PCP churn: 8–12% of patients switch providers annually. Most rosters don't reflect it until claims adjudicate months later.
  • Multi-payer conflict: A single patient appears on three payer feeds with three different PCPs. Manual reconciliation burns 10–15 FTE hours monthly.

ElevateIQ · Ask who joined, churned, or switched PCPs this week — and get a verified, current list back in plain language.

ElevateCare · Roster

< 24 hrs

Roster reconciliation cycle

vs. 30–90 day industry average

1 source

of truth per patient

Payer feeds + EHR + claims unified

100%

Attribution transparency

Active, new, and churned — always current

HEDIS Care Gaps

Close gaps while there's still time.

Quality reporting consumes staff time and resources that could go to patient care — and most care gaps surface long after the window to act has narrowed. ElevateCare gives care teams a continuous, connected view of every open measure, so closure happens steadily across the year.

  • Late discovery: Care gaps surface long after they could've been closed — outreach windows shrink with every passing month.
  • Disconnected closure: Identification, outreach, order, and result validation live in separate systems. Closures fall through the cracks.
  • Triage by ease, not impact: When every measure looks the same, teams start with the easiest gaps — not the ones that move the needle for patients or stars.

ElevateIQ · Ask which open measures carry the most weight for your Star ratings, then route that cohort straight into outreach.

ElevateCare · Care Gaps

Continuous gap visibility

HEDIS measures tracked the moment data lands — so care teams see what's open, what's closing, and what needs attention without waiting for a quarterly report.

Year-round closure

Outreach starts in January, not October — every measure has time to close inside the performance year.

Coordinated workflows

Identification, outreach, scheduling, and result validation all live in one place — no more hand-offs lost between systems.

Impact-led prioritization

Gaps surfaced by patient impact and star-rating leverage — so teams act on what moves outcomes, not just what's easy.

ElevateCare · RAF & Risk

Baseline RAF

1.24

Actual RAF

1.50

460 HCC documentation gaps identified

5–6%

Avg. HCC codes missed per patient annually

$2–4M

Revenue lost per 10K lives from documentation gaps

Prospective

Review — before encounters happen, not after

Risk Adjustment · RAF

Stop leaving RAF revenue on the table.

5–6% of eligible HCCs go undocumented every year. ElevateCare surfaces prospective analysis before encounters — so your RAF score reflects your true population risk.

  • Documentation gaps: The average practice misses 5–6% of eligible HCC diagnoses per patient each year — silent revenue loss that compounds.
  • Reactive workflows: RAF reviews run in Q4, after most encounters are gone. Prospective opportunities disappear before anyone acts on them.
  • Audit exposure: Retroactive chart reviews raise compliance risk. CMS clawbacks average 2–4% of prior-year payments on audited claims.

ElevateIQ · Ask where documentation gaps cluster by provider or condition, and see the RAF and revenue impact before the next encounter.

Cohort Analytics

Target the cohort. Not the average.

Whole-population averages hide where risk and opportunity actually sit. ElevateCare segments members into living cohorts by condition, risk, utilization, and SDOH — so teams can size an intervention and act on the group that will move outcomes most.

  • Averages hide risk: Population-level metrics blend the stable majority with the few members driving cost — the group that needs action stays invisible.
  • Stale registries: Condition lists built once a year are out of date by spring. Risk moves through the year; a static registry doesn't.
  • Untargeted intervention: Without size and impact modeled up front, teams launch programs on cohorts that were never going to move the numbers.

ElevateIQ · Describe a cohort in plain English — it's assembled across every connected source, with size and impact previewed before you commit.

ElevateCare · Cohorts

Rising-risk diabetics

2,310lives

$1.2M RAF lift available

30-day post-discharge

680lives

Elevated readmission exposure

Overdue AWV · age 65+

1,540lives

412 quality gaps open

Polypharmacy · 10+ meds

905lives

Medication review priority

Living cohorts — re-sized as new data lands

ElevateCare · Live Dashboard

See it in action.

Roster, RAF, and care gaps — unified in a single operational dashboard. Switch between views to see how ElevateCare surfaces the actions that matter most.

ElevateCare · Live Dashboard

Live
All Payers
All Months
All Providers
All Status
All Products
All Patient Status
All Enrollment Status
Search…

Total Patients

29,007

Filtered Results

26,032

For

Jan 2026

#PatientDemographicsEligibilityRecertificationCare TeamLast ContactActions
PA

Patient A

Policy # XXXXXXXX

52 yrs / Female

01/22/1974

10/01/2023

Active

09/30/2026

Active

Care Team 1

Organization 1

PB

Patient B

Policy # XXXXXXXX

74 yrs / Female

04/06/1952

03/04/2024

Active

12/31/2026

Active

Care Team 2

Organization 1

PC

Patient C

Policy # XXXXXXXX

70 yrs / Male

10/12/1955

09/01/2021

Active

12/31/2026

Active

Care Team 3

Organization 1

PD

Patient D

Policy # XXXXXXXX

39 yrs / Male

12/31/1986

02/01/2025

Active

06/30/2026

Expiring Soon

Care Team 4

Organization 1

PE

Patient E

Policy # XXXXXXXX

26 yrs / Male

09/17/1999

04/21/2025

Active

02/28/2026

Expired

Care Team 4

Organization 1

PF

Patient F

Policy # XXXXXXXX

30 yrs / Female

05/21/1996

09/01/2024

Active

08/31/2026

Active

Care Team 5

Organization 1

PG

Patient G

Policy # XXXXXXXX

10 yrs / Female

01/23/2016

08/01/202307/31/2026

Active

07/31/2026

Active

Care Team 6

Organization 1

Showing 7of 26,032 filtered · Eligibility & recertification reconciled across payer feeds in near real-time

How It Works

ElevateCare is the foundation. ElevateIQ is the accelerant.

Roster accuracy, RAF precision, and care gap closure aren't possible without a trusted data foundation. ElevateCare builds that foundation — then ElevateIQ puts AI on top of it.

Intelligence Layer

ElevateIQ

Natural-language AI that queries your ElevateCare data in real time — surfacing answers, care plans, and opportunities at patient, cohort, and population scale.

Operational Foundation

ElevateCare

Accurate patient attribution, prospective HCC coding, and real-time HEDIS gap tracking — the verified operational truth your programs run on.

RosterQualityRiskAnnual VisitsProvider DashboardHospitalizationHCCCohort BuildingTransitions of Care
EHR · Claims · Pharmacy · Labs · SDOH — unified via FHIR, HL7, CCDA, APIs & SFTP
Connected Modules

Nine modules. One operational truth.

Every module reads from the same unified roster, claims, and clinical layer — so action in one place updates the whole picture instantly.

Roster

Accurate patient attribution, eligibility tracking, and physician mapping with aligned accountability.

Quality

Tracks HEDIS and claims-based measures. Identifies care and documentation gaps continuously.

Risk

Stratifies populations by clinical and utilization risk for proactive outreach and care management.

Annual Visits

AWV scheduling and completion tracking — closes preventive care gaps at scale.

Provider Dashboard

Real-time KPIs and performance metrics. Visibility for leaders and care teams in one view.

Hospitalization

Tracks admissions, discharges, and ED visits. Supports post-discharge follow-up workflows.

HCC

RAF score tracking and coding compliance. Closes HCC documentation gaps at point of care.

Cohort Building

Segments populations by clinical criteria — enables targeted outreach and care programs.

Transitions of Care

Reduces readmissions and avoidable utilization. Coordinates across post-acute settings.

ElevateIQ · Intelligence Layer

Then ask it anything.

ElevateIQ sits on top of your ElevateCare data — transforming every roster record, RAF gap, and care measure into a natural-language answer your team can act on in seconds, not weeks.

  • Ask natural-language questions about patients and populations
  • Run reports in minutes — not weeks
  • Analyze care gaps, documentation gaps, and utilization patterns
  • Generate AI-assisted care plans and surface hidden opportunities
ElevateIQLive
4,821 attributed members

Selected Question

Which diabetic members are overdue for an A1C test and haven't had a visit in the last 6 months?

Claude, OpenAI & Ollama ensemble — orchestrated over your ElevateCare data in real time

Cohort Analysis

From a prompt to a cohort in seconds.

Describe the cohort in plain English. ElevateIQ assembles it across roster, claims, EMR, pharmacy, and SDOH — then previews size, RAF impact, gap closure ROI, and outliers before you commit a single workflow.

> prompt
“Show diabetic patients with HbA1c > 9 not seen in the last 6 months.”
→ cohort built · 1.4s
Patients
1,247
RAF lift
$890K
Overdue AWVs
412
  • Natural-language queries across every connected data source
  • Pre-flight RAF, quality, and revenue impact before you act
  • Push the cohort straight into outreach, AWV, or care management workflows
Chart Summary

Pre-visit summaries clinicians actually read.

One paragraph. Active diagnoses, open gaps, risk factors, recent utilization, prior visit highlights — generated automatically before every appointment, with source citations and confidence flags.

Patient · MRN 8842116
Pre-visit · 7:42 AM

62yo M with T2DM (HbA1c 9.2, Apr), HTN, CKD-3. AWV due — last completed 14 months ago. Open quality gaps: retinal screen, diabetic foot exam, ACE/ARB renewal. ED visit 6 weeks ago for atypical chest pain — workup negative. Recent A1c trending up despite metformin + glipizide. Suggested:intensify therapy, schedule retinal + foot exam at today's visit, refill ACE.

EMR · 12 sourcesConfidence 94%Citations: 8
  • Real-time, EMR-native — generated overnight, refreshed at check-in
  • Aligned to AWV, HCC capture, and quality measure workflows
  • Every claim traceable to source data with confidence scoring
Why Elevate

Built for how VBC actually works.

A single intelligence layer that integrates with the infrastructure you already use — and unifies the tools your teams rely on every day.

01

Real-time attribution

Roster updates in hours, not months. Care teams always know who they're managing — and who just joined or left.

02

Prospective RAF capture

HCC opportunities surfaced before encounters, not during retroactive year-end reviews that create audit risk.

03

Year-round gap closure

HEDIS gaps identified the moment data lands — not discovered in Q3 when the window to act is nearly gone.

04

Works with your existing systems

Integrates with Epic, Cerner, Athena, and every major payer feed. Adds intelligence on top of the infrastructure you already have.

Tailored Intelligence

One platform. Every care model.

Configurable for the organizations driving the value-based care ecosystem.

Payors
Population-level risk stratification, advanced analytics, and coordinated care intelligence.
Health Systems
Enterprise-scale integration, compliance, and population-level oversight across complex networks.
ACOs & IPAs
Network-wide attribution, quality tracking, and streamlined value-based reporting.
FQHCs
Whole-person care intelligence for federally qualified health centers serving underserved communities.
Independent Clinics
Turnkey care management, annual visit workflows, and accessible performance dashboards.
Case Studies

ElevateIQ in the real world.

Two stories that show what happens when AI intelligence meets everyday care operations.

Roster Intelligence

Patient switches PCP, find out first.

Near real-time roster adjudication ensures attribution is always accurate, so care teams never manage a patient that isn't theirs — or miss one who is.

Challenge

Roster changes lagged by weeks. Care managers were contacting patients who had switched providers, and missing newly attributed members entirely.

Action

ElevateIQ continuously reconciles attribution data across payer feeds, EHR rosters, and claims — surfacing PCP changes within hours, not weeks.

Result

Outreach accuracy jumped dramatically. Care teams stopped wasting effort on patients who left and started capturing value from newly attributed members immediately.

Real-time

Roster updates

Zero

Stale outreach

100%

Attribution accuracy

End-of-Day Prep

Tomorrow's patients, prepared today.

Physicians and care coordinators use ElevateIQ to scrub EMR data and generate patient summaries for the next day's schedule — enabling proactive, not reactive, care.

Challenge

Providers walked into appointments cold — no time to review records, identify gaps, or prepare targeted questions. Care was reactive by default.

Action

ElevateIQ runs an end-of-day EMR scrub, surfaces open gaps, flags risk factors, and generates a structured pre-visit summary for every patient on tomorrow's schedule.

Result

Providers arrive prepared. Gap closure rates increased, visit quality improved, and care coordinators spend time acting — not searching for information.

Daily

Pre-visit summaries

Proactive

vs. reactive care

Higher

Gap closure rates

Interoperability by Design

We don't replace systems — we connect them.

Seamless integration via FHIR, HL7, CCDA, APIs, and SFTP. Works across major EHRs, payer systems, and healthcare ecosystems — connecting the infrastructure you already have, not replacing it.

EpicCernerAthenaeClinicalWorksAllscriptsNextGen
Leadership

Where clinical expertise meets intelligent innovation.

ND

Dr. Nimish Dharia

CEO & CFO

Strategic vision and financial discipline. Physician leader driving the intersection of clinical excellence and data intelligence.

AJ

Adam J. Voice

COO

Leads operations and performance. Ensures seamless delivery and measurable client success.

CR

Cirron Ray

CSO

Leads strategy and growth. Scaling Elevate's market presence across value-based care organizations.

CD

Christel Dagher

Head of Strategy & Operations

Turns strategy into disciplined execution. Aligns teams, priorities, and delivery so clients see value fast.

Ready to Elevate

Elevate intelligence.
Elevate outcomes.

Whether you're a health system, ACO, IPA, independent clinic, or payer — we'll model how ElevateCare360 transforms your data into action.

contact@elevatehealthcaresolutions.com