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Solutions / RA Horizon

RA Horizon Platform

A purpose-built SaaS platform for Medicare Advantage risk adjustment forecasting and optimization.

Maximize Your Risk Adjustment Revenue

RA Horizon combines actuarial methodology with production-grade machine learning to deliver high-fidelity RAF forecasting for Medicare Advantage plans.

Unlike generic analytics platforms, RA Horizon was built ground-up by FSA actuaries with deep HCC expertise to support clinical review workflows and audit readiness.

Infrastructure options designed for HIPAA-aligned operations
Security program aligned to SOC 2 Trust Services Criteria
Audit-support documentation package available

RAF Score Forecasting

Predict end-of-year RAF scores with confidence intervals at the member level.

Predictive HCC Models

ML-based models identify likely HCC conditions based on pharmacy, lab, and claims signals.

Suspect Condition Lists

Prioritized outreach lists delivered to care managers and coders weekly.

Performance Dashboards

Real-time tracking of RAF capture rate, coding accuracy, and revenue impact.

Provider-Level Analytics

Identify provider-level coding gaps and support targeted CDI initiatives.

API Integration

Connect to your existing data warehouse, EMR, or care management platform.