# Best Value-Based Reimbursement Software *By [Emma Stein](https://research.g2.com/insights/author/emma-stein)* The medical industry’s revenue and payment systems are moving toward value-based reimbursement, an alternative payment model that reflects the increasingly patient-focused, value-based delivery of care within health care systems. Value-based reimbursement solutions help reduce payer health care costs by optimizing the payer-provider relationship and payment structures. Value-based reimbursement solutions can exist as software, service, or a hybrid of both; the latter allows health care software vendors to equip health care organizations with the analytics and expertise necessary to revamp existing reimbursement models. By deploying value-based reimbursement strategies, hospitals and health care practices can better and more accurately compensate the services rendered to a patient. To qualify for inclusion in the Value-Based Reimbursement category, a product must: - Identify high value care payment method bundles and insurance providers - Mine and analyze patient and population data - Model and analyze impact of value-based reimbursement models - Offer flexible or customizable contract templates ## Category Overview **Total Products under this Category:** 33 ## Trust & Credibility Stats **Why You Can Trust G2's Software Rankings:** - 30 Analysts and Data Experts - 300+ Authentic Reviews - 33+ Products - Unbiased Rankings G2's software rankings are built on verified user reviews, rigorous moderation, and a consistent research methodology maintained by a team of analysts and data experts. Each product is measured using the same transparent criteria, with no paid placement or vendor influence. While reviews reflect real user experiences, which can be subjective, they offer valuable insight into how software performs in the hands of professionals. Together, these inputs power the G2 Score, a standardized way to compare tools within every category. ## Best Value-Based Reimbursement Software At A Glance - **Easiest to Use:** [Therap Services](https://www.g2.com/products/therap-services/reviews) ## Top-Rated Products (Ranked by G2 Score) ### 1. [Therap Services](https://www.g2.com/products/therap-services/reviews) Therap Services is the national leader in HIPAA-compliant electronic documentation solutions for organizations in Long-Term Services and Supports (LTSS), Home and Community-Based Services (HCBS), and other human services industries. The system caters to a wide range of providers, including those serving individuals with intellectual and developmental disabilities, community employment and vocational rehabilitation programs, special education and school health services, aging and home health agencies, and autism programs. Therap's key features include electronic health record (EHR) capabilities, electronic visit verification (EVV) to track and manage service visits, comprehensive incident reporting and management tools, and person-centered planning tools to support individualized service goals and outcomes. Additionally, the system includes functionality to manage waiver slots and waiting lists, helping providers streamline day-to-day operations. **Average Rating:** 4.6/5.0 **Total Reviews:** 219 **Seller Details:** - **Seller:** [Therap](https://www.g2.com/sellers/therap) - **Year Founded:** 2003 - **HQ Location:** Torrington, US - **Twitter:** @therapservices (513 Twitter followers) - **LinkedIn® Page:** https://www.linkedin.com/company/97019/ (169 employees on LinkedIn®) **Reviewer Demographics:** - **Who Uses This:** Director, Quality Assurance Coordinator - **Top Industries:** Hospital & Health Care, Individual & Family Services - **Company Size:** 71% Mid-Market, 19% Small-Business #### Pros & Cons **Pros:** - Document Management (11 reviews) - Customer Support (9 reviews) - Therapy Services (9 reviews) - Features (8 reviews) - Ease of Use (7 reviews) **Cons:** - Poor Navigation (3 reviews) - Time Consumption (3 reviews) - Access Difficulty (1 reviews) - Billing Issues (1 reviews) - Expensive (1 reviews) ### 2. [Foothold](https://www.g2.com/products/radicle-health-foothold/reviews) Electronic documentation software for I/DD and behavioral health service providers. Our software offers case management, client tracking, and an Electronic Health Record (EHR) all under one roof. Visit our website to speak with one of our specialists. We are HIPAA-compliant, federally certified as an EHR for Meaningful Use, and offer full interoperability as you navigate the new landscape of care coordination and value-based care. Our software is ideal for human services and I/DD agencies, particularly those that offer multiple programs such as mental health, substance use disorder, housing and employment. **Average Rating:** 4.8/5.0 **Total Reviews:** 30 **Seller Details:** - **Seller:** [Radicle Health](https://www.g2.com/sellers/radicle-health) - **Year Founded:** 2021 - **HQ Location:** Walnut Creek, CA - **LinkedIn® Page:** https://www.linkedin.com/company/radiclehealth/ (114 employees on LinkedIn®) - **Ownership:** Privately Held **Reviewer Demographics:** - **Top Industries:** Mental Health Care, Non-Profit Organization Management - **Company Size:** 63% Mid-Market, 33% Small-Business ### 3. [iClinic](https://www.g2.com/products/iclinic/reviews) iClinic® is a fully certified EHR that is designed to improve your workflow, reduce time spent on data entry while preparing you to meet quality payment program requirements and additional incentives so that you focus on providing care for your patients. **Average Rating:** 4.3/5.0 **Total Reviews:** 8 **Seller Details:** - **Seller:** [MDLand International](https://www.g2.com/sellers/mdland-international) - **Year Founded:** 1999 - **HQ Location:** New York, NY - **LinkedIn® Page:** https://www.linkedin.com/company/mdland/ (75 employees on LinkedIn®) **Reviewer Demographics:** - **Company Size:** 44% Mid-Market, 44% Small-Business #### Pros & Cons **Pros:** - Convenience (1 reviews) - Document Management (1 reviews) - Ease of Use (1 reviews) - Easy Access (1 reviews) - Efficiency (1 reviews) **Cons:** - Poor Customer Support (1 reviews) - Poor Responsiveness (1 reviews) - Time Delays (1 reviews) ### 4. [LexisNexis Keep Contact](https://www.g2.com/products/lexisnexis-keep-contact/reviews) MemberPoint cleans and enhances your membership files with information from our vast public records repository which uses our proprietary LexID linking technology and HPCC computing platform. **Average Rating:** 4.4/5.0 **Total Reviews:** 7 **Seller Details:** - **Seller:** [LexisNexis Risk Solutions](https://www.g2.com/sellers/lexisnexis-risk-solutions) - **HQ Location:** Alpharetta, Georgia, United States - **LinkedIn® Page:** https://www.linkedin.com/company/lexisnexis-risk-solutions (9,775 employees on LinkedIn®) **Reviewer Demographics:** - **Company Size:** 43% Mid-Market, 29% Small-Business ### 5. [MIPSPRO](https://www.g2.com/products/mipspro/reviews) The landscape of the Merit-based Incentive Payment System (MIPS) has changed. The penalties have increased and the Centers for Medicare & Medicaid Services (CMS) has made it harder to achieve a high score. Whether your goal is to achieve the best scores simply avoid the penalty, MIPSpro provides a wide range of services to not only help with MIPS submission, but also improve your score. No matter where you are in your MIPS journey, our years of unmatched experience provide you with the opportunity to take the next steps in value-based care. **Average Rating:** 5.0/5.0 **Total Reviews:** 2 **Seller Details:** - **Seller:** [Healthmonix](https://www.g2.com/sellers/healthmonix) - **Year Founded:** 2001 - **HQ Location:** Malvern, US - **LinkedIn® Page:** https://www.linkedin.com/company/2916304 (44 employees on LinkedIn®) **Reviewer Demographics:** - **Company Size:** 50% Mid-Market, 50% Small-Business ### 6. [SoftCure Hospital Software](https://www.g2.com/products/softcure-hospital-software/reviews) SoftCure has TPA treatment management & predefined treatment packages that speed up the operational work by eleminating the time consuming manual processes. The covers the most effective marketing module that provide you the facility to send bulk SMS & Email with an attractive Website for your hospital. **Average Rating:** 5.0/5.0 **Total Reviews:** 2 **Seller Details:** - **Seller:** [SoftCure Hospital](https://www.g2.com/sellers/softcure-hospital) - **Year Founded:** 2014 - **HQ Location:** Noida, India - **Twitter:** @softjoin (3 Twitter followers) - **LinkedIn® Page:** https://www.linkedin.com/company/No-Linkedin-Presence-Added-Intentionally-By-DataOps (1 employees on LinkedIn®) **Reviewer Demographics:** - **Company Size:** 300% Mid-Market, 50% Small-Business ### 7. [TriZetto CareAdvance Provider](https://www.g2.com/products/trizetto-careadvance-provider/reviews) CareAdvance Provider is part of the Cognizant line of TriZetto Healthcare Products portfolio of software products that help healthcare organizations enhance revenue growth, drive administrative efficiency, improve cost and quality of care and improve the member and patient experience. **Average Rating:** 4.5/5.0 **Total Reviews:** 2 **Seller Details:** - **Seller:** [Cognizant](https://www.g2.com/sellers/cognizant) - **Year Founded:** 1994 - **HQ Location:** Teaneck, NJ - **Twitter:** @Cognizant (708,900 Twitter followers) - **LinkedIn® Page:** https://www.linkedin.com/company/1680/ (355,708 employees on LinkedIn®) - **Ownership:** NASDAQ:CTSH **Reviewer Demographics:** - **Company Size:** 50% Small-Business, 50% Enterprise ### 8. [HealthQx](https://www.g2.com/products/healthqx/reviews) HealthQx is an analytics platform and data services solution designed for health plans that want to foster deep clinical and cost analysis through episodic claim grouping and network analysis. **Average Rating:** 5.0/5.0 **Total Reviews:** 1 **Seller Details:** - **Seller:** [Change Healthcare](https://www.g2.com/sellers/change-healthcare) - **Year Founded:** 2007 - **HQ Location:** Nashville, US - **Twitter:** @Change_HC (35,849 Twitter followers) - **LinkedIn® Page:** https://www.linkedin.com/company/change-healthcare/ (4,773 employees on LinkedIn®) - **Ownership:** NASDAQ: CHNG **Reviewer Demographics:** - **Company Size:** 100% Small-Business ### 9. [Provation Apex](https://www.g2.com/products/provation-apex/reviews) Provation® Apex is an intelligent procedure documentation platform which is designed to help your team reach peak productivity. **Average Rating:** 4.0/5.0 **Total Reviews:** 1 **Seller Details:** - **Seller:** [Provation Medical](https://www.g2.com/sellers/provation-medical) - **Twitter:** @ProVationMed (927 Twitter followers) - **LinkedIn® Page:** https://www.linkedin.com/company/provation-medical/ (184 employees on LinkedIn®) **Reviewer Demographics:** - **Company Size:** 100% Small-Business #### Pros & Cons **Pros:** - Templates (1 reviews) **Cons:** - Integration Issues (1 reviews) ### 10. [AccuReg](https://www.g2.com/products/accureg/reviews) AccuReg offers a full suite of all critical front-end RCM process solutions that hospital Patient Access departments need. **Seller Details:** - **Seller:** [AccuReg Software](https://www.g2.com/sellers/accureg-software) - **HQ Location:** Eden Prairie, Minnesota, United States - **Twitter:** @AccuRegSoftware (398 Twitter followers) - **LinkedIn® Page:** https://www.linkedin.com/company/optum/ (95,430 employees on LinkedIn®) ### 11. [ActiveASSIST](https://www.g2.com/products/activeassist/reviews) ActiveASSIST provides all the tools a facility needs to identify, manage and track the entire financial assistance process including the workflow around managing the patient account. ActiveASSIST is fully integrated with the Patient Account Rank Order (PARO) presumptive charity system to help identify financial counseling prospects. The PARO system determines the likelihood that a patient will qualify for financial assistance based on demographic data modeled from surrounding communities and historical charity approvals previously made by the hospital. **Seller Details:** - **Seller:** [HealthWare Systems](https://www.g2.com/sellers/healthware-systems) - **Year Founded:** 1998 - **HQ Location:** Elgin, US - **Twitter:** @HealthWareSys (83 Twitter followers) - **LinkedIn® Page:** https://www.linkedin.com/company/335513/ (20 employees on LinkedIn®) ### 12. [Apex Connect](https://www.g2.com/products/apex-connect/reviews) mySuite is a cloud-based solution designed to manage patient revenue cycle through payment processing and patient-centric communication. **Seller Details:** - **Seller:** [Apex Revenue Technologies](https://www.g2.com/sellers/apex-revenue-technologies) - **Year Founded:** 1981 - **HQ Location:** Nashville, Tennessee, United States - **LinkedIn® Page:** http://www.linkedin.com/company/revspring (698 employees on LinkedIn®) ### 13. [Aver Operationalize](https://www.g2.com/products/aver-operationalize/reviews) Aver is a platform that coordinates payers, providers, and patients into a single value-based payment solution. **Seller Details:** - **Seller:** [Aver](https://www.g2.com/sellers/aver) - **Year Founded:** 2019 - **HQ Location:** Raleigh, US - **LinkedIn® Page:** https://www.linkedin.com/company/averidentityservices/ (6 employees on LinkedIn®) ### 14. [Cedar Gate Platform](https://www.g2.com/products/cedar-gate-platform/reviews) Cedar Gate Technologies offers a comprehensive analytics platform designed to empower healthcare organizations in the transition to value-based care. This platform provides advanced tools for analyzing and visualizing data, enabling users to lower costs, improve care quality, and enhance patient experiences. By integrating predictive and prescriptive analytics, Cedar Gate's solution helps identify performance drivers, predict health and utilization risks, and pinpoint variations before they impact clinical or financial outcomes. Key Features and Functionality: - Healthcare Benefits Analytics: Allows self-funded employers, payers, and advisors to model and optimize benefits plan designs, access enriched member data from multiple sources, benchmark performance against regional and national data, track the impact of point solutions over time, and visualize data through self-service dashboards and automated reporting. - Value-Based Care Analytics: Enables payers and providers to identify and mitigate variations in cost and quality, pinpoint high-performing providers and quality drivers using advanced benchmarking tools, create condition-, disease-, and risk-based cohorts to reduce care gaps, model value-based care contracts to meet clinical and financial performance goals, and share insights via customizable dashboards and automated reports. - Enterprise Data Management: Integrates data from over 50 disparate sources into a unified data lake, normalizing and enriching information to provide a single source of truth. This system ensures high-quality, secure data storage in the cloud, facilitating near real-time data capabilities for actionable insights. Primary Value and Problem Solved: Cedar Gate's analytics platform addresses the challenges healthcare organizations face in transitioning from fee-for-service to value-based care models. By providing a unified, integrated solution that combines data management, advanced analytics, and actionable insights, the platform enables organizations to: - Achieve cost reduction and improve care quality by identifying and addressing performance variations. - Enhance patient and member experiences through data-driven decision-making and personalized care plans. - Streamline operations and reporting with automated tools and customizable dashboards. Ultimately, Cedar Gate's platform empowers healthcare organizations to succeed in value-based care by transforming complex data into actionable strategies that drive better outcomes for patients and financial performance for providers and payers. **Seller Details:** - **Seller:** [Cedar Gate Technologies](https://www.g2.com/sellers/cedar-gate-technologies) - **Year Founded:** 2014 - **HQ Location:** Greenwich, US - **LinkedIn® Page:** https://www.linkedin.com/company/cedar-gate (1,174 employees on LinkedIn®) ### 15. [Denefits](https://www.g2.com/products/denefits/reviews) Denefits is a leading complete payment solutions platform used by businesses alike across many industries. We use technology to provide businesses the opportunity to solve one of the world’s biggest challenges: accessibility to necessary services. Our no fee payment processing, flexible payment plans, and automated accounts receivable features have allowed thousands of businesses across many industries to make their services affordable to customers. Whether you have experienced issues with payment disputes, payment plans, or following up on past due payments, Denefits automated software has the solution for you. **Seller Details:** - **Seller:** [Denefits](https://www.g2.com/sellers/denefits) - **Year Founded:** 2016 - **HQ Location:** Irvine, US - **LinkedIn® Page:** https://www.linkedin.com/company/denefits/ (26 employees on LinkedIn®) ### 16. [Edifecs Value-Based Care](https://www.g2.com/products/edifecs-value-based-care/reviews) Unify your clinical and financial data to deliver better care at a lower cost. **Seller Details:** - **Seller:** [Edifecs](https://www.g2.com/sellers/edifecs) - **Year Founded:** 1996 - **HQ Location:** Bellevue, US - **LinkedIn® Page:** https://www.linkedin.com/company/26173 (909 employees on LinkedIn®) ### 17. [Enli CareManager](https://www.g2.com/products/enli-caremanager/reviews) Enli CareManager is a Best in KLAS population health management platform that enables provider organizations to pursue population health initiatives and close gaps in care. **Seller Details:** - **Seller:** [Enli](https://www.g2.com/sellers/enli) - **Year Founded:** 2014 - **HQ Location:** Greenwich, US - **LinkedIn® Page:** https://www.linkedin.com/company/cedar-gate (1,174 employees on LinkedIn®) ### 18. [Episode Manager](https://www.g2.com/products/episode-manager/reviews) A value based payment solution for payers that want to integrate prospective payment models into their existing claims workflows. **Seller Details:** - **Seller:** [Change Healthcare](https://www.g2.com/sellers/change-healthcare) - **Year Founded:** 2007 - **HQ Location:** Nashville, US - **Twitter:** @Change_HC (35,849 Twitter followers) - **LinkedIn® Page:** https://www.linkedin.com/company/change-healthcare/ (4,773 employees on LinkedIn®) - **Ownership:** NASDAQ: CHNG ### 19. [EZ-INFO](https://www.g2.com/products/ez-info/reviews) Empower your organization to adapt with a user-friendly solution, identifying and mitigating risk. While profitability improves, so will your patients experiences and outcomes. **Seller Details:** - **Seller:** [Citra](https://www.g2.com/sellers/citra) - **HQ Location:** N/A - **LinkedIn® Page:** https://www.linkedin.com/company/No-Linkedin-Presence-Added-Intentionally-By-DataOps (1 employees on LinkedIn®) ### 20. [FinThrive](https://www.g2.com/products/finthrive/reviews) Thrive holistically re-engineers the revenue cycle throughout the patient's journey, from patient access to accurate clinical documentation and coding to proper reimbursement. **Seller Details:** - **Seller:** [FinThrive](https://www.g2.com/sellers/finthrive-8de60521-193c-4680-bef8-12ae1891e9f8) - **Year Founded:** 2016 - **HQ Location:** Plano, Texas, United States - **LinkedIn® Page:** https://www.linkedin.com/company/finthrive (2,670 employees on LinkedIn®) ### 21. [MyMipsScore](https://www.g2.com/products/mymipsscore/reviews) Modular system that allows you to design the program's interface. Could be maintained in the cloud or installed on premises **Seller Details:** - **Seller:** [Darena Solutions](https://www.g2.com/sellers/darena-solutions) - **Year Founded:** 2009 - **HQ Location:** Chesterfield, US - **LinkedIn® Page:** https://www.linkedin.com/company/darenasolutions/ (10 employees on LinkedIn®) ### 22. [OLIVE](https://www.g2.com/products/olive-ai0-olive/reviews) Olive's Reimbursement Management solution was designed to streamline the claims process for healthcare providers, aiming to enhance revenue cycles and reduce administrative burdens. By leveraging artificial intelligence and automation, Olive sought to expedite claim statuses, manage denials, and prioritize accounts receivable, thereby improving cash flow and operational efficiency. Key Features and Functionality: - Claim Status Monitoring: Automated frequent checks on claim statuses to accelerate cash flow and support successful appeal efforts. - Denials Management: Identification and collection of essential medical documents, with automatic resubmission of claims in the correct format to ensure approval. - Accounts Receivable Prioritization: Analysis of claims to determine high-value opportunities, assisting teams in focusing on the most promising revenue sources. - Underpayment Recovery: Utilization of payment variance analysis to prioritize underpayment appeals, maximizing collections and enhancing recovery team efficiency. Primary Value and User Solutions: Olive's Reimbursement Management aimed to simplify the complex reimbursement landscape for healthcare providers. By automating routine tasks and providing intelligent prioritization, the solution sought to reduce manual workload, minimize claim denials, and improve overall financial performance. This allowed healthcare professionals to dedicate more time to patient care, confident in the efficiency and reliability of their revenue cycle processes. Please note that as of October 2023, Olive AI has ceased operations, and its business units have been acquired by other companies. **Seller Details:** - **Seller:** [Olive - Healthcare's AI Workforce](https://www.g2.com/sellers/olive-healthcare-s-ai-workforce) - **HQ Location:** Columbus, US - **LinkedIn® Page:** https://www.linkedin.com/company/oliveai (704 employees on LinkedIn®) ### 23. [OM1 Outcomes](https://www.g2.com/products/om1-outcomes/reviews) OM1 is the Principal Investigator for the U.S. Agency for Healthcare Research and Quality (AHRQ) Outcome Measures Framework (OMF), a project aimed at harmonizing existing outcomes measures and producing new sets of outcomes measures across more expensive health care conditions. **Seller Details:** - **Seller:** [OM1](https://www.g2.com/sellers/om1) - **Year Founded:** 2015 - **HQ Location:** Boston, Massachusetts, United States - **LinkedIn® Page:** https://www.linkedin.com/company/om1-inc. (131 employees on LinkedIn®) ### 24. [Payer Compass](https://www.g2.com/products/payer-compass/reviews) Payer Compass is dedicated to restoring rationality to the cost of care. We focus squarely on tackling the most elusive problems in today’s healthcare landscape: spiraling costs and associated lack of price transparency. For self-insured organizations, our innovations and services are driving down the costs of healthcare claims reimbursement. And for health plans, we are minimizing overall spend on claims pricing, administration, and processing. **Seller Details:** - **Seller:** [Zelis](https://www.g2.com/sellers/zelis-4372baaa-6f0e-4dc5-985f-68564a568d01) - **Year Founded:** 2016 - **HQ Location:** Bedminister, NJ - **Twitter:** @ZelisHealthcare (455 Twitter followers) - **LinkedIn® Page:** https://www.linkedin.com/company/zelis (2,915 employees on LinkedIn®) ### 25. [PDPM Coach](https://www.g2.com/products/pdpm-coach/reviews) Patient Pattern creates software solutions to improve patient care by helping healthcare professionals identify and communicate risk across care settings. **Seller Details:** - **Seller:** [Patient Pattern](https://www.g2.com/sellers/patient-pattern) - **HQ Location:** N/A - **LinkedIn® Page:** https://www.linkedin.com/company/No-Linkedin-Presence-Added-Intentionally-By-DataOps (1 employees on LinkedIn®) ## Parent Category [Health Care Operations Software](https://www.g2.com/categories/health-care-operations)