Pareto Intelligence
Pareto Intelligence provides healthcare analytics and consulting solutions that help health plans and risk-bearing providers turn complex data into actionable intelligence across risk adjustment, revenue, quality, and member activation. The company's suite includes RevenueIQ, StarIQ, and RewardsIQ, with specialized support for CMS RADV audits. Pareto serves Medicare Advantage, ACA Exchange, Managed Medicaid, and Commercial markets.
- Data & Analytics
- Insurance Technology
- Healthcare Technology
- Regulatory & Compliance Technology
- Software Only
Funding
Founders
Founder details are not available yet.
Product
Problem
Healthcare organizations in Medicare Advantage, ACA Exchange, Managed Medicaid, and Commercial markets struggle to turn vast amounts of data into clear, actionable intelligence. They need more than isolated tools—they need a comprehensive perspective across risk, revenue, quality, and member activation to remain competitive and compliant.
Solution
Pareto Intelligence provides a unified analytics platform and consulting practice that delivers predictive intelligence for healthcare leaders. The company applies the Pareto Principle to healthcare and provider data, filtering out noise to surface what matters most. Its suite includes RevenueIQ for risk adjustment accuracy and defensible revenue insight, StarIQ for quality analytics, RewardsIQ for member activation, and Payment Integrity solutions. Consulting services embed experienced operators alongside client teams to design, operationalize, and tune programs that boost risk adjustment revenue, Stars/Quality, and compliance, with hands-on support for CMS RADV audits including chart prioritization, retrieval, coding review, and financial exposure analysis.
Target Audience
Primary customers are health plans and risk-bearing providers across Medicare Advantage, Medicaid, Health Insurance Exchange, and Commercial markets, including healthcare leaders focused on improving financial performance, quality outcomes, and member engagement.
Features
- RevenueIQ unified analytics engine that strengthens risk adjustment accuracy and provides clear, defensible revenue insight
- Intelligent risk adjustment analytics that prioritize risk gaps to ensure compliant documentation and accurate risk scores
- Star & Quality Analytics (StarIQ) for building resilient star strategies amid changing CMS rules
- Member Rewards & Activation (RewardsIQ) for driving member engagement and quality outcomes
- Payment Integrity (MSP & COB) solutions for identifying and recovering improper payments
- Consulting and managed services covering strategy implementation, risk assessment, operating model design, data integrity, and RADV audit preparedness
- Dedicated RADV CMS audit support with chart prioritization, retrieval, coding review, and financial exposure analysis