Nine Modules. One Operating System.
Every VBC OS™ module is purpose-built for value-based care and deployed as a unified, interoperable platform — or embedded individually via API. All modules are CTF™ — Customizable to Fit your organization's workflows and payer contracts.
Nine Integrated Modules. One Operating System.
Every VBC OS™ module is purpose-built for value-based care and deployed as a unified, interoperable platform — or embedded individually via API. All modules are CTF™ — Customizable to Fit your organization's unique requirements, workflows, and payer contracts.
Quality Management
Quality measures calculations, real-time care gap dashboards, and omnichannel member outreach — across MA, Medicaid, ACA, and commercial populations.
Stars Rating Optimization
Real-time CMS Stars performance dashboards, measure weighting models, cut-point analysis, and "what-if" scenario planning to drive sustainable rating improvement.
Risk Adjustment + Documentation Auditor
Prospective HCC identification, retrospective gap analysis, CMS submission tracking, automated documentation auditor, and RADV audit defense — across CMS-HCC V28, ACA, and Medicaid models.
Network Intelligence & Referral Optimization
Performance-based specialist identification, premium network design, referral optimization engine, cost-share steering, and predictive referral management — the VBC network intelligence platform.
Care Management & Population Health
Hospitalization-risk stratification, validated across a multi-model LLM ensemble, interdisciplinary care team coordination, specialist engagement, ADT alerts, Remote Patient Monitoring, and MOC care plan compliance facilitation.
Financial & Utilization Analytics
Real-time service fund performance, PMPM cost trending, admits/1,000 benchmarks, pharmacy analytics, and provider stop-loss analysis for risk-bearing organizations.
Data Warehouse as a Service
Healthcare-specific enterprise data warehouse aggregating claims, EMR, lab, pharmacy, and enrollment data — with pre-built CMS, Quality measures, and state regulatory reporting capabilities.
HL7 FHIR® Interoperability
Bi-directional FHIR R4 integration with main EMR solutions and HIEs — delivering clinical intelligence within your existing workflows without a separate portal.
VBC Professional Services
Expert advisory for MSO back-office operations, risk contract structuring, market entry strategy, VBC program selection, and service area expansion — from a team with 30+ years of payer leadership.
See How the VBC OS™ Applies to Your Organization
Every module above is deployed differently depending on whether you're a health plan, ACO, primary care group, health system, HCIT vendor, or TPA.
Ready to Deploy the VBC OS™?
Join healthcare organizations across the country using Ensure Data Solutions to achieve top-tier quality ratings, optimize risk revenue, manage total cost of care, and deliver measurably better population health outcomes.