Value Based Care Model Revenue Optimization for Healthcare Organizations
Chirok Health helps healthcare organizations succeed in value-based care by aligning clinical documentation, quality reporting, and revenue workflows to what payers actually measure and reimburse.
- Built for risk-based, shared-savings, and quality-driven contracts
- Connects care delivery to quality scores and revenue
- Designed for population health, quality, and finance leaders
Why Healthcare Organizations Need a Dedicated VBC Model Support?
Value-based care changes how revenue is earned, how risk is measured, and how quality is audited. That shift requires an operating model built specifically for value-based performance.
Revenue depends on outcomes over time
VBC revenue is earned across the full patient journey, not a single visit or claim.
Documentation controls risk and payment
Accurate diagnosis capture drives risk scores, incentives, and shared-savings revenue.
Quality scores determine reimbursement
HEDIS, STAR, and gap closure directly impact bonuses and penalties.
Care teams and finance must stay aligned
Clinical actions and financial results must be tracked in the same performance model.
Payers validate VBC performance year-round
RADV and quality audits continuously review contract accuracy.
Value-Based Care Coding Services
Accurate, risk-aligned coding that protects quality scores, risk adjustment, and value-based reimbursement.
Risk-Aligned Coding Accuracy
Codes reflect true patient complexity to support RAF scores and contract performance.
Quality-Driven Code Capture
Diagnosis and procedure codes support HEDIS, STAR, and gap-closure reporting.
Audit-Ready Code Validation
Coding is continuously validated to reduce RADV, quality, and payer audit exposure.
Value-Based Care Clinical Documentation Integrity Services
Clinical documentation integrity ensures diagnoses, conditions, and care plans accurately support quality scores, risk models, and value-based reimbursement.
Quality Measure Abstraction
Clinical evidence tied to HEDIS, STAR, and care-gap closure is captured, validated, and prepared for compliant value-based reporting.
Risk & Retrospective Validation
Patient records are reviewed to confirm diagnoses and conditions that support accurate risk scores and contract-level reimbursement.
Value-Based Care Revenue Cycle Management Services
Revenue cycle workflows aligned to value-based contracts, quality performance, and risk-based reimbursement models.
Demographic Registration
Accurate patient and payer data from the start
Prior Authorization
Payer-aligned approvals before care is delivered
Charge Capture
Every billable service recorded correctly
Edits & Rejections Management
Fix claim errors before submission
Denials Management
Recover and prevent denied claims
Payment Posting
Post payments quickly and accurately
Credit Balance Resolution
Identify and resolve overpayments
Insurance Follow-Up
Work unpaid claims to reduce AR
Correspondence & Appeals
Manage payer letters and appeals
Value-Based Care RCM Staff Augmentation
Dedicated Chirok Health specialists extend your value-based care revenue cycle, supporting risk, quality, and contract performance across your organization.
VBC Workflows Supported Across Any EHR
Chirok Health staff operate directly inside your EHR to support value-based care without disrupting existing workflows
EHR expertise for VBC
- Audit-ready VBC workflows from day one
- No risk of EHR-related errors
- Validated data for risk and quality
Who We Serve Under the Value-Based Care Model?
Our value-based care solutions support organizations responsible for population health, risk, quality performance, and contract-based reimbursement.
Medical Groups
Support primary care and specialty groups managing risk adjustment, care gaps, and quality performance across value-based contracts.
Specialty Practices
Ensure specialty-driven diagnoses, care pathways, and outcomes are accurately captured for VBC risk and quality programs.
Ambulatory & Outpatient Organizations
Align ambulatory care delivery with HEDIS, utilization, and cost-of-care performance measures.
Hospitals & Health Systems
Coordinate inpatient and outpatient documentation, quality reporting, and risk capture across system-wide value-based contracts.
Risk-Bearing Organizations
Support ACOs, MSOs, and provider-led entities managing shared savings, downside risk, and payer performance targets.
Value-Based Care Compliance, Built for Performance
Chirok Health ensures risk scores, quality results, and contract revenue are supported by compliant, audit-ready value-based workflows.
Clinically supported risk capture
Quality measures you can stand behind
VBC-aligned coding and abstraction
Continuous compliance assurance
Why Healthcare Organizations Choose Chirok Health for Value-Based Care?
Value-based care requires precision across quality, risk, and revenue. Chirok Health brings accountability to every part of the model.
Built specifically for value-based contracts
Performance tied to contract outcomes
Human expertise supported by automation
Full transparency across VBC performance
Designed for long-term value-based growth
Measurable Impact of Our Value-Based Care Optimization
What organizations achieve when clinical insight, risk validation, and human review work together.
Net New HCCs Identified per Patient
Previously undocumented risk conditions are identified and clinically validated to strengthen RAF accuracy.
Chronic Conditions Confirmed per Patient
Known conditions are consistently captured, supported, and aligned with value-based care requirements.
Acceptance Rate on Identified HCCs
Validated conditions meet payer and CMS standards for risk adjustment and audit review.
Incremental Opportunity Beyond AI Outputs
Human clinical expertise identifies additional risk and quality opportunities missed by AI-only models.
Get in Touch
Let’s talk about your value-based care goals
Whether you’re managing shared-savings contracts, downside risk, or quality programs, our team is here to help you align care, documentation, and revenue.
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Got Questions?
We’ve Got Answers!
Organizations often struggle with inaccurate risk capture, inconsistent documentation, fragmented data, and financial volatility. Without strong clinical and operational alignment, value-based contracts can increase risk instead of improving margins.
Chirok Health strengthens the foundation of value-based care by improving risk adjustment accuracy, documentation integrity, coding consistency, and compliance governance—ensuring organizations are paid appropriately for patient complexity and outcomes.
We support organizations participating in Medicare Advantage, ACOs, MSSP, shared savings programs, and other alternative payment models, including hybrid environments where FFS and value-based contracts coexist.
Risk adjustment directly impacts benchmarking, shared savings, and financial sustainability. Missed or unsupported diagnoses can lead to undervalued patient populations, reduced revenue, and increased audit exposure.
We reduce volatility by creating predictable, defensible workflows around documentation, coding, and quality capture—helping organizations stabilize revenue, forecast performance, and minimize retrospective surprises.
Our approach emphasizes clinician-friendly workflows, focused education, and concurrent support, enabling providers to document accurately without disrupting care delivery or increasing administrative burden.
Yes. We align clinical documentation and coding accuracy with quality and outcome measures, ensuring organizations don’t have to choose between compliance, care quality, and financial performance.
All VBC services are delivered with audit readiness at the core, following CMS, RADV, and OIG standards. This ensures documentation and coding can withstand payer scrutiny while supporting reported outcomes.
Most organizations see improvements in risk capture, documentation quality, and performance visibility within 90–120 days, with sustained gains as governance and maturity increase.
Yes. Our solutions are designed for enterprise health systems managing multiple contracts, payer rules, and populations, providing consistent oversight, analytics, and executive-level reporting.