Stop Just Aligning. Start Executing.
Your payers and providers agree on value-based care goals. But fragmented data, disconnected systems, and manual workflows are killing your results. Caesar Health is the first platform built for synchronized payer-provider execution.
You're Aligned on Goals. But Execution is Broken.
• 100% of providers and 97% of payers say their VBC goals are aligned
• But they're operating in parallel, not in concert
• Result: Technology investments fail to deliver ROI, and VBC scaling stalls
• Only 33% rate data integration as "excellent"
• Only 46-53% confident in patient data accuracy
• Data flows in batches (daily/weekly), not real-time
• Multiple EMRs across provider network = data silos
• Providers use Epic, athenahealth, Cerner
• Separate care coordination platform (Innovaccer, Arcadia)
• Payers have their own analytics tools
• Integration costs: $50K-$200K per connection
• Annual platform costs: $500K-$2M+ for care coordination alone
• 100% of organizations use AI
• But only 40% are fully committed to AI adoption
• Concerns: Hallucinations, transparency, governance
• Only 30-32% offer extensive AI training
• Care managers work in 2-3 different systems
• Care gaps identified days after encounters (batch data)
• No real-time feedback loop to providers
• Duplicate documentation across platforms
The Operating System for Value-Based Care
The Caesar Health VBC Architecture
• AI-first EMR with automated documentation
• Real-time care gap alerts during patient encounters
• Quality measure tracking embedded in workflows
• Risk stratification visible to providers at point of care
• Unified patient registry across all providers in network
• Predictive analytics for hospitalization risk, care gaps
• Care team coordination with shared worklists
• Automated patient outreach (calls, texts, emails)
• Real-time data sharing with health plans (not retrospective claims)
• Shared quality dashboards showing HEDIS, Star Ratings, MIPS performance
• Collaborative care management: Payer and provider care managers see same data
• Transparent financial tracking: Shared savings, quality bonuses, contract performance
Key Capabilities
Patient schedules appointment → AI pre-visit planning identifies care gaps → During encounter, provider sees alerts → Orders placed in-system → Quality dashboard updates in real-time
Impact:
• 3x faster care gap closure vs. batch-based systems
• 40% improvement in HEDIS scores in first year
• 80% reduction in manual chart review
AI analyzes clinical data, claims, SDoH → Identifies high-risk patients → Auto-assigns to care manager → Suggests evidence-based interventions
Impact:
• 25% reduction in preventable hospitalizations
• $500-$1,000 PMPM savings for high-risk populations
• Earlier interventions before patients decompensate
Care managers, providers, specialists, social workers share one platform → Collaborative care plans → Secure messaging and handoffs
Impact:
• Eliminate duplicate documentation across systems
• 50% faster care team communication
• Improved patient experience with coordinated outreach
Health plan gets secure, real-time access to quality metrics → Shared dashboard → Automated reporting → Financial reconciliation
Impact:
• Eliminate trust issues with transparent, auditable data
• Faster payment of quality bonuses
• Stronger payer relationships through collaboration
Use Cases by Organization Type
Challenge: Managing care across independent practices with different EMRs
Caesar Health Solution: Deploy across all network providers or integrate with existing EMRs → Unified patient registry → Real-time quality reporting to CMS
Results:
• $2-5M additional shared savings in year one (10K-patient ACO)
• Eliminate $500K-$1M in care coordination platform costs
Challenge: Improving Star Ratings while managing medical costs
Caesar Health Solution: Provider-facing tools that make quality improvement easy → Real-time Star Ratings dashboard → Automated HEDIS gap closure campaigns
Results:
• 0.5-1.0 Star Rating improvement in 2 years
• $50-$100 PMPM revenue increase from higher ratings
• 10-15% reduction in medical costs
Challenge: Transitioning employed providers from fee-for-service to value-based mindset
Caesar Health Solution: EMR that embeds VBC workflows → Provider scorecards → Financial incentives tied to platform metrics
Results:
• Faster provider adoption of VBC behaviors
• Improved quality metrics without provider burnout
Challenge: Managing complex, high-need populations with social determinants of health
Caesar Health Solution: Integrated SDoH screening → Care coordination for behavioral health + medical comorbidities → Real-time alerts for ER visits
Results:
• 20-30% reduction in ER utilization
• Better management of super-utilizers
Pricing That Aligns with Your Success
Payer-Sponsored: $2-5 PMPM
(payer pays, providers get free access)
Provider-Sponsored: $1-3 PMPM
(ACO pays based on attributed lives)
$500-$1,000/provider/month
Includes full EMR + population health
Best for smaller ACOs or medical groups
% of incremental shared savings or quality bonuses
Fully aligned incentives (we win when you win)
Current State Costs:
• Care coordination platform: $1.5M/year
• EMR costs across network: $2M/year
• RCM vendor fees: $1M/year
• Total: $4.5M/year
Caesar Health Cost:
$3 PMPM × 50,000 lives × 12 months = $1.8M/year
Net Savings: $2.7M/year
Plus Performance Gains:
• Additional shared savings: $2-5M/year
• Quality bonus improvements: $500K-$1M/year
Total Value: $5-8M/year
Ready to Lead the Value-Based Care Revolution?
Join the ACOs, health plans, and health systems that are moving beyond fragmented systems to unified, AI-powered collaboration.