Hexplora

Hexplora is a healthcare analytics and data management company that specializes in value-based care (VBC) performance optimization. The company's HEX platform provides pre-built dashboards, scorecards, and over 300 healthcare-specific measures and KPIs designed for ACOs, IPAs, physician groups, and care management organizations. The platform has processed 500 million claims and serves 2 million members across its client base.

The company's core offerings span four main modules: analytics (predictive, performance, revenue cycle, and quality), management (care management, HCC risk, population health, and provider engagement), reporting (enterprise reporting and MassHealth CP), and data warehousing. As a Microsoft Gold-Certified partner and HEDIS-certified vendor, Hexplora combines healthcare domain expertise with cloud infrastructure capabilities to deliver data integration, quality reporting, and actionable insights for value-based care models.

Hexplora reports $800 million in savings generated for clients and has established partnerships with ACOs, MCOs, and community-based organizations primarily in the northeastern United States. The company has developed specialized solutions for Medicare ACOs, HEDIS quality reporting, MIPS reporting, HCC reporting, and MLTC quality reporting.

Choose Hexplora if your organization needs a comprehensive, pre-built analytics platform specifically designed for value-based care models with immediate access to HEDIS and MIPS reporting capabilities. The company's domain expertise in ACO performance measurement and HCC risk adjustment makes it particularly suitable for organizations pursuing shared savings or managing Medicare Advantage populations.

Expect a platform-based approach rather than custom development, with implementation leveraging their existing dashboard library and healthcare-specific data models. The Microsoft Gold partnership suggests strong technical infrastructure, though organizations should verify regional support availability and assess fit for non-Medicare populations.

Hexplora operates exclusively in healthcare with particular depth in value-based care models and government payer programs. The company's HEDIS certification, specialized modules for Medicare ACOs, MIPS quality reporting, HCC risk adjustment, and MLTC programs demonstrate deep healthcare regulatory knowledge. Their platform addresses specific healthcare workflows including care gap closure, member attribution, provider engagement, and quality measure reporting aligned with CMS requirements.

The ideal client is a Medicare ACO, managed care organization, IPA, or physician group with 10,000+ attributed lives transitioning to value-based care models who needs turnkey analytics infrastructure with HEDIS/MIPS reporting capabilities. Organizations seeking to optimize HCC coding, close quality gaps, and demonstrate performance improvement through established healthcare measures will find the platform well-aligned with their needs.