Risk Optimization

Providers – Get ready for the next phase of Value Based Care

“Programs that use two-sided risk (i.e., shared savings and losses) appear to have the greatest impact.”

The Future of Value-Based Payment: A Road Map to 2030

“The next decade of payment transformation must focus on expanding the most effective APMs that utilize two-sided risk”

The Challenge of Risk Bearing Organizations

Risk Bearing Healthcare Providers have a very complex challenge of balancing cost versus quality of care. Leaders of Risk Bearing Organizations must constantly keep an eye on quality of care while managing cost. With today’s revenue cycle and capitation management systems, providers can run day-to-day operations; however, visibility, reporting and optimization are a growing challenge.

While Risk Bearing Healthcare Providers have access to all of the data, they are not able to effectively use the data to improve margins and care quality.

Bloom Solution

Risk Optimization Engine

Our Risk Optimization Engine brings together cost data, quality data, capitation data and EMR data into a common coordinate system.

Bloom's Analytics and AI Models process this integrated data to help drive value for risk bearing organizations

Solution Value

Reduce medical loss ration by advanced benchmarking and provider engagement

Reduce administrative costs by automating utilization and cost management tasks

Improve compliance through automated reporting

Improve patient outcomes through proactive engagement

Improve patient and provider satisfaction

Bloom Value’s Risk Optimization Engine combines your data with external data to answer these questions. Just AskBloom!


  • What is going to be my margin and financial picture this year?
  • Which providers are driving utilization outside norms after accounting for disease burden?

Compliance Director

  • What is the Credentialing Status of my provider population?
  • How can I keep on top of my reporting requirements to payors and regulators?

Quality Director

  • What are my quality targets and how do I achieve them?
  • Where are my HCC gaps and what actions do I need to take to address them?

Utilization Director

  • How can I avoid missing Auth SLA deadlines without scrambling at the last minute?
  • How can we scrutinize fewer auths?


  • Which providers are over-referring?
  • How can we improve member outcomes while reducing costs?

Request A Demo

Find out how your organization can realize value in just six weeks and three clicks.

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