Accountable care, payer–provider and capitated risk.
No national identifier and accountability that moves annually — both configuration problems rather than product problems.
A different problem, and the same architecture
The United States has no national patient number, and responsibility for a person’s cost of care moves between organisations. Both are things you set up rather than limits of the product. We match identity across sources on the balance of probability, and the organisation carrying the risk is a dated entry rather than a fixed field.
Accountable care
Attribution, total cost of care against benchmark, quality measures and shared savings.
Payer–provider
Prior authorisation, documentation templates, notifications and claims-driven attribution.
Capitated risk
Risk adjustment with auditable gap closure rather than opportunistic coding.
Care management
The billable care-management programmes, each with its own time threshold tracked against the record.
Payer and provider
Prior authorisation, document templates, notifications and claims — where payers and providers actually meet.
Value-based care
Shared savings, quality measures and the care-management billing that funds the work.
Risk and population health
Risk adjustment that is auditable, and population management that reaches the people behind the number.
Interoperability
Nationwide exchange, bulk access, and the certifications held by the organisation rather than by the supplier.
Compliance
Information blocking, good-faith estimates, conditions of participation — and an honest account of what a platform can and cannot hold on your behalf.
Deployment
How a US organisation actually adopts this, and what it holds versus what we hold.
One thing a US buyer should test us on
Responsibility moves each year, but commvita’s record of who is responsible stores only when the entry was created, not which year it covers. So you cannot currently rebuild the history for a member, and a new entry overwrites the old one instead of sitting alongside it.
It is on the platform’s own defect register with the fix named. It is stated here because it is exactly the kind of thing that should be found in due diligence rather than after signature.