Risk Adjustment Data Integrity Analysis & Lineage (RADIAL)

Wakely developed the Risk Adjustment Data Integrity Analysis and Lineage (RADIAL) reporting tool to help our ACA individual and small group clients identify data leakage that impacts risk adjustment outcomes. Tracking data lineage across data sources allows plans to clearly identify potential data leakage (missing records or data elements). The impact of these issues is prioritized based on the overall impact to risk adjustment results. The tool provides drill-through analytics to allow plans to quickly investigate the identified issues and trace data lineage.

We believe that this set of analytics provides transparency and insight to ACA health plans that want to review data integrity. Wakely has been helping issuers review their ACA risk adjustment data since 2014, providing industry-leading analytics.

Identifying and stopping data leakage at the source.

Wakely ingests multiple data sources, including EDGE data, to provide transparency in risk score difference. Drill-through analytics allow clients to track data integrity issues across data sources.

  • Member & Claim level prioritization based on impact to risk adjustment
  • HCC and risk adjustment summaries
  • Data comparison and tracking between data sources

Wakely offers RADIAL on a fixed-fee or per-run schedule. The suggested run schedule is:

  • Run 1: November/December
  • Run 2: January/February
  • Run 3: March

Unique products and tools.

Wakely has developed these industry-leading products and tools, which empower our clients to make highly informed strategic decisions.

Request a Product Demo

Wakely Medicare Advantage Competitive Analysis Tool (WMACAT)

Allows health plans to compare Medicare Advantage benefits and market information at the national, state, and county levels, to evaluate plan design and performance.

Get product details

Wakely National Risk Adjustment Reporting (WNRAR)

Provides risk adjustment metrics from 35 states and 19 million lives.

Get product details

Risk Score Opportunities (RSO)

Identifies and prioritizes members who are most likely to have a condition that has not been coded.

Get product details

Wakely Plan Valuation Model (WPVM)

Supports pricing, mental health parity compliance, cost and utilization analysis and more.

Get product details

Risk Adjustment Payment & Identifying Discrepancies (RAPID)

Gets the most out of your EDGE data.

Get product details

Wakely Analytics Health Operations Optimization (WAHOO)

Helps payers and providers optimize financial performance with a complete package of services and tools.

Get product details

Wakely Affordable Care Act Competitive Analysis Tool (WACACAT)

Allows users to interactively explore market metrics.

Get product details

Wakely Risk Assessment (WRA)

Provides a transparent, open-code, high-performance risk assessment model.

Get product details

Wakely Risk Insight (WRI)

Includes two major components: The Medicare National Report (MNR) and WRI-MA. Both pinpoint drivers of profitability and compare them to national benchmark data.

Get product details

Wakely Risk Insight National Reporting Project (WRINR)

Identifies key profitability drivers for the individual and small group markets.

Get product details

Wakely Medicare Repricing Analysis Tool (WMRAT)

Aids the comparison of payment rates across multiple lines of business, categories of service, geographic locations, and providers.

Get product details

Wakely ACA Database (WACA)

Contains the most robust and detailed ACA data available in the industry.

Get product details

Risk Adjusted Payments & Identifying Discrepancies for Medicare Advantage Plans (RAPID-M)

Helps plans optimize risk scores by identifying RAPS and EDS inconsistencies

Get product details

Ready to learn more about RADIAL?