Solutions For Payers

Creating Cultural, Financial, and Clinical Alignment

A Population Health Management Platform for Payers

Lightbeam provides a complete, end-to-end population health platform for health plans managing patients at risk. We combine everything from clinical and claims data to biometric and social data. We provide a single location for actionable data, making program management simple. Our core platform allows you to effortlessly maximize revenue and reduce the future cost of care.

Poulation Heatlh Diagram

Everything You Need to Thrive as a Health Plan

The more clinical, claims, and data feeds we can consume, the more we can help your plan perform. Our software provides easy to visualize insights so you can quickly identify who in your health plan needs care so you can take immediate action. Our platform gives you the flexibility to create custom dashboards, track performance over time, and learn where you can improve clinical and financial outcomes.

Boost HCC Codes, HEDIS Scores, and STAR Ratings

Lightbeam’s population health platform provides solutions for health plans, enabling care management, risk stratification, analytics, and many more applications to help drive clinical and financial improvements. By leveraging aggregated and normalized data, health plans can enhance the accuracy of HCC coding to drive the member population's RAF scores, leading to increased benchmarks. In addition, our population health technology helps you improve HEDIS measures and STAR ratings.


The South Bend Clinic: Using Analytics to Thrive Under Value-Based Contracts

Since The South Bend Clinic began using face sheets in August 2017, this tool has helped the organization raise their Medicare Advantage STAR Rating from an average of 4.1 stars to 4.6 stars out of 5. As a measure of HCC coding impact, the year-to-date Percent Coding Validation (PCV) percentage is trending 12% higher than the same month in 2017, and is already only 22% from exceeding the final PCV performance percentage for 2017.

All Roads Lead to Population Health

Many payers will help their providers focus on earning bonuses or avoiding penalties, while others will do nothing. Wherever you fall, Lightbeam can help you incorporate the right population health strategies to remain a step ahead in improving patient outcomes and reducing unnecessary spending, outcomes, and unnecessary costs.

Mohawk Industries

“This is a great example of the care coordination and the synergistic effect of all the services working to ensure the right services are in place at the right time for the right patient.”

Cara Bramlett, Mohawk On-site Clinics

View Mohawk Industry's Patient Impact Story

Our team provides the solutions you need to maintain control, no matter what the future of healthcare brings.

Evaluate Risk Adjustment Factor (RAF) Impact

HCC codes directly impact the overall RAF score for MA plans. If providers do not code correctly, reimbursements will be inaccurate. Even an increase as little as .01 in RAF can be worth $8-9 per member per month.

Analyze Current HCC Coding Opportunities

Did you know that each year, CMS assumes conditions for patients no longer exist? Even for conditions like “amputation”. With access to claims, labs, and clinical data, healthcare organizations can identify “suspect codes” that suggest a patient has a condition that has not yet been diagnosed.

Maximize Quality Measures & Negotiate STAR Bonus

Lightbeam provides visibility into HCC coding for MA plans, showing patients HCC eligibility status which (when coded accurately) increases the average RAF score for the population, generating reimbursement. Lightbeam also shows “suspect” codes that may otherwise be missed.

Lightbeam places this information at the point of care, when the patient is in the exam room, ensuring conditions are accurately tracked and coded.

Our Platform

Data Aggregation

Combine data from multiple sources to create a unified patient registry from which actionable insights can be generated.

Data Analysis

Measure real-time performance, cost, risk, and productivity against strategy and goals to prevent unnecessary spending.

Risk Stratification

Focus your care coordination resources on patients prioritized by concurrent and predictive risk models.

Cohorts Builder

Enable resources with little or no programming experience to initiate complex queries and generate specific lists of patients.


Artificial Intelligence (AI)

Identify patients who are at risk of developing or undiagnosed chronic conditions.

Referral Management

Improve the efficiency of referrals by visually matching patients to the ideal provider based on 6 essential data points.

Lightbeam HIE

Streamline clinical data across complex environments and care settings leveraging a health information exchange.

Patient Engagement

Communicate bi-directionally with your patients using custom messaging tailored to personality type, including care plan steps, medication and visit reminders.

Physician Engagement

Engage providers at the point of care with the actionable insights they need to maximize quality and coding opportunities.

Care Management

Assign, monitor, and track custom or evidence based care plans and steps for patients enrolled in care management program.


Save time and simplify the end of year reporting experience to enhance your ACO participation efforts.

HCC Coding

Engage providers with coding compliance and suspecting information to ensure the highest levels of accuracy and reimbursement.

Our Services

Lightbeam advisors are value-based contract experts. They analyze the structure of your contracts to help you focus on the areas to optimize performance.
Lightbeam's Benchmark Assessment service provides personalized reports that analyzes your patient data. Areas of comparison include percentage of spend based on specialist, procedures, rendering provider, and more. Each area is compared to those around you and the national average.
Lightbeam helps you prioritize care manager resources by identifying high-cost, high-risk patients and then stratifying them by risk, looking at historical costs of care, diagnosis codes, social conditions, etc.
In context of your contracts and staff resources, Lightbeam leverages the power of data aggregation to identify patient populations that would benefit the most from care management intervention, based on preventative care programs.

Meet other organizations who are already saving with Lightbeam.

Millennium FL In the 2017 performance year, Millennium Physician Group's Track 3 ACO earned an impressive $29.7 million in shared savings.
Rio Grande Valley TX In the 2015 performance year, Rio Grande Valley Health Alliance saved $8.6 million leveraging Lightbeam’s Population Health Solutions.
South Bend Clinic IN Since The South Bend Clinic partnered with Lightbeam, the ACO has been able to supply reports to physicians based on aggregated claims and clinical information.
Maury Regional TN Serving six primary counties, Maury Regional Health is the largest healthcare provider between Nashville and Huntsville, Alabama.

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