How AI Analytics Drive Value-Based Care Success

Deeya Chopra
Nov 20
2 min read

A robotic hand and human hand touch fingertip to fingertip with a glowing DNA strand in the background on a dark blue backdrop. — Zynix’s AI analytics identify risk gaps and improve care quality across VBC programs

The shift to value-based care (VBC) requires that healthcare organizations do more than treat illnesses; they must also predict, document, and accurately track outcomes.

But with thousands of patients, endless regulations, and shrinking margins, this is easier said than done.

That’s where AI-driven value-based care analytics come in. Platforms like Zynix help close documentation gaps, track quality measures, and ensure that every patient and diagnosis is accounted for in real-time.

Value-Based Care Analytics: The Essentials

Value-based care ties provider reimbursement to clinical outcomes rather than volume. Key components include:

Accurate coding (e.g., Hierarchical Condition Categories, or HCCs)
Closing care gaps (like overdue screenings)
Chronic condition management
Patient satisfaction & engagement

Zynix’s care analytics ecosystem — including ZynGap and ZynPredict — empowers provider groups and Accountable Care Organizations (ACOs) to operationalize these VBC principles with precision.

What AI Can Do for VBC

Chart highlighting benefits of Zyngap's AI in healthcare: HCC detection, quality gap closure, risk stratification, and real-time dashboards.

The Financial Impact

Value-based care hinges on risk-adjusted payments and quality bonuses. Missing documentation = lost revenue.

According to the NAACOS 2023 ACO Savings Report:

MSSP ACOs generated $5.2 billion in gross savings and $2.1 billion in net savings in 2023
That’s an average of $504 in net savings per beneficiary

AI analytics ensures that diagnoses are captured, risk scores are accurate, and quality reporting is complete — translating directly into shared savings and CMS bonuses.

See CMS Fast Facts

Real-World Use Case: Coding Accuracy with AI

A multi-specialty group using Zynix’s platform:

Increased their RAF score by 21% within 6 months
Detected 64% more missed HCCs vs. manual audit
Improved coding-to-encounter accuracy from 78% to 92%

They also saw an 11% increase in shared savings year-over-year.

ZynGap: Real-Time HCC & Quality Intelligence

Zynix’s ZynGap engine sits atop your EMR and billing data to

Flow chart with 4 steps o: 1. Scan notes, 2. Flag documentation, 3. Suggest code, 4. Alert quality teams.

It integrates directly with existing workflows, offering actionable insights during or immediately after patient visits. Combined with ZynPredict, care teams can proactively manage risk and close the loop on chronic disease pathways.

Why Timing Matters

HCC coding and quality gaps are time-sensitive:

Missed diagnoses = lower RAF = lower capitation/reimbursement
Unclosed quality gaps = missed quality incentives

AI helps providers act in real time, not months later during retrospective audits. Zynix One simplifies this by unifying all analytics in one real-time dashboard.