The operating system for an attributed panel.
Alara Population Health turns payer files, claims, and clinical feeds into one panel, one gap list, and one work queue, with every figure defined and every action recorded.
Built around how the work actually happens.
The product follows a five-stage loop: data arrives, identities resolve, panels attribute, gaps surface, work closes. Each module below owns one part of that loop, and the "Add to Work List" action appears wherever a decision is made, so nothing found in an analysis stays in an analysis. Every screen was shaped with the people who do the work, not for a demo.
Eight modules. Pick one.
Five have a page of their own; the other three are described below on this page.
DashboardMembership, P&L, and risk at a glanceOn this page 
Work ListQueues, Command Center, productivityFull page 
Panel 360Attribution and membershipFull page 
Data ManagementFiles, schema, pipeline, qualityFull page 
Risk IQHCC gaps, RAF, audits, submissionsFull page 
Q-TrackHEDIS, Stars, MIPS, and MVPFull page 
Care BridgeTransitions of careOn this page 
AdminUsers, locations, roles, notificationsOn this page 
Dashboard
Membership, financial performance, and risk-adjustment health across the attributed panel.
- Four collapsible sections: Membership Health, Financial (P&L with an FMLR gauge and band breakdown), Risk Adjustment, Population Risk Profile.
- Clickable KPI cards that open the owning module.
- Global month and payer filters that drive every page.
- A live indicator that turns amber or red when a data feed is stale or offline, so an outage never looks like an empty panel.
Work List
Your queue, team oversight, and coder productivity.
Read the full Work List page Guide: Putting care gaps to work- My Work List: open, in progress, overdue, done in the last 7 days; a light/medium/heavy load bar; personal stats.
- Command Center: unassigned, overdue, and due-in-24-hours alerts; workload by person, department, and location; round-robin redistribution of one person's pending work; open any coder's queue as they see it.
- Productivity: open-opportunity burn-down, gap closure trend with sweep-deadline projection, work by location, contractor and staff panels.
- Review time is captured automatically with an on-screen indicator and a consent notice, and idle time is excluded.
- Every metric page states what it will not support as a conclusion about a colleague. Where a provider has not ruled, the coder's acceptance rate shows N/A, never 0%.
Panel 360
Membership and attribution: who is in the panel, how they got there, and where they are.
Read the full Panel 360 page Guide: Patient attribution- Enrollment: total, new this month, existing, terminated, with monthly member flow and a volatility rate.
- Three attribution methods: Payer Roster, MSSP/ACO, and MCP/PCF claims-based plurality waterfalls over a configurable lookback. The reasoning is stored per member.
- Demographics, provider panels, and a county-level member map.
- Member 360: identity, RAF, recaptured HCCs, outside-provider closures, open gaps, and segment, with enrollment history, HCC gaps, an evidence matrix, the RAF calculation itself, and CMS data.
- Membership is stored one record per enrolled month, so the product answers both "how many over the period" and "how many right now."
Data Management
File delivery, schema configuration, pipeline health, data quality, and source contracts.
Read the full Data Management page Guide: Medicare Advantage payer files- Inbox: files in storage with duplicate detection, manual upload, batch history.
- Schema: when a payer adds, renames, or drops a column, the pipeline stops and asks rather than guessing. Versioned file types; automatic delimiter detection.
- Pipeline: a two-panel column-mapping editor with sample values; pipeline log; batch errors by file and type; a scheduler with cadence presets.
- Quality: a continuous check engine that rolls into an A–F grade and a 0–100 health score. Findings name a steward and link to the source file. Datasets that fail badly enough are withheld rather than served.
- Identity Resolution: most duplicate records resolve automatically; ambiguous pairs queue for review.
- Sources: a delivery calendar of what each source owes and whether it landed, and payer contracts with allocation rate, MLR target, profit share, and the HEDIS measure set the contract is scored against.
Did the file arrive, was it readable, is it correct. Schema alerts, column mapping, pipeline scheduling, and an A–F data quality grade.
Risk IQ
Risk-adjustment analytics and the compliance audit workflow.
Read the full Risk IQ page Guide: HCC recapture rate Guide: CMS-HCC V28 transition- HCC Explorer: the panel's documented clinical picture. Burden, disease groups, comorbidity pairs, a full HCC catalog, and a benchmark of your prevalence against the national Medicare Advantage rate, condition by condition.
- RAF Gap Analysis: gaps by status (new, not revalidated, suspect at high, medium, and low confidence), ranked by RAF value rather than count, with the evidence and its source behind each one. View by member, provider, or location. Bulk-add to Work List. Gaps closed by providers outside your panel count toward recapture but leave your actionable list.
- Financial Summary: a ten-section P&L mirroring the payer report: premium revenue with Part A/B/D components, projected risk adjustment, medical claims with IBNR, capitation, pharmacy, reinsurance, total cost, and net surplus or deficit. MLR and FMLR kept deliberately distinct. PMPM throughout.
- ASM Submissions: build, validate, approve, and send supplemental diagnosis files to a payer, with findings grouped by reason and tracking through receipt or rejection.
- Audits and Templates: draw and lock a sample, route review through work lists, record findings, and produce a stratified extrapolation with a 90% confidence interval. Headline figures show the conservative lower bound. Pre-built templates modeled on OIG protocols: High-Risk Diagnosis, Telehealth, Opioid.
- Suspecting rules, not black boxes: conditions that should be documented but never were are surfaced by multi-signal clinical rules (a diagnosis plus a confirming drug, procedure, or repeat occurrence), each with its citation, its evidence card, and a measured precision that retires low-value rules.
- Semantic search over the HCC catalog: type a condition in your own words and find the category. The model runs inside the platform's own region; nothing leaves it.
- Full CMS-HCC V28 scoring: demographics, condition mapping, hierarchies, interactions, and normalization, with the V24 crosswalk.
Q-Track
Quality reporting: HEDIS and CMS Stars measures, MIPS and MVP.
Read the full Q-Track page Guide: MIPS checklist- Performance Metrics: projected Star rating, weighted measure score, projected quality bonus payment, open gaps, and a per-measure table with weight, benchmark, rate, and an on-track chip.
- HEDIS Workbench: a five-state gap lifecycle from Total Workable through Open, Captured (Pending), Submitted (Awaiting), and Plan Closed (Reconcile). Managers see the full pool with team load and bulk assignment; specialists see their own assignments. Gaps close automatically when the qualifying result lands in the data.
- MIPS: overview with a ranked "what moves the needle" list; a Quality best-six optimizer that maximizes total points; Cost; Improvement Activities with retained evidence; Promoting Interoperability; an Inventory matrix showing which source feeds each measure and which need an EHR extract; and Submission with a readiness checklist, a locked and fingerprinted score snapshot, and a printable audit packet. The snapshot is handed to your registry or EHR for filing; Alara is not itself a Qualified Registry.
- MVP: pathways, subgroups, and traditional-versus-MVP scoring side by side all year.
- Gap closure follows three archetypes (document now, order and await a result, control an outcome), and an hourly result watcher closes gaps automatically when a lab or vital lands in range.
In development.Care Bridge
Transitions of care. Discharge and follow-up workflows that connect hospital events to the Work List.
Guide: Transitions of careScope and timing will be published when the module ships.
Transitions of care. Discharge and follow-up workflows that connect hospital events to the Work List.
Admin
Users, locations, roles and permissions, and notification settings.
- Invitation-only users with NPI, specialty, and provider type. Deactivate, never delete.
- A true location hierarchy (organization, region, site) with inherited scope.
- Twelve system roles, from organization administrator to panel-scoped provider, ranked so that no one can assign a role above their own. Permissions are granted per resource, and every screen, button, and figure checks a permission rather than a role name.
- A notification scoreboard: delivered, suppressed, click rate, outcome rate, and categories that have never fired. One permission-aware inbox.
Users, locations, ranked roles and permissions, and a notification scoreboard.
What the platform takes in.
Alara Population Health is built for the files a risk contract already produces.
- Payer enrollment rosters and eligibility, payer-identified HCC and quality gap files, and the year-end risk report.
- CMS encounter, risk score, and payment files (MAO-004, MOR, MMR).
- Professional and institutional claims, and pharmacy claims from PBMs.
- EHR encounter extracts (eClinicalWorks format supported today), lab results, and vitals.
- Financial statements.
Files arrive through secure cloud storage folders on a schedule the product tracks, or by manual upload. Spreadsheets and delimited files are accepted with automatic delimiter detection, and column mappings are confirmed by an administrator before processing starts. Outbound, the platform generates supplemental diagnosis files for payers in the Verscend 2.2.9 and RA ASM 4.1 formats.
Data quality, continuously
65 automated checks, seasonality-aware anomaly detection, and freshness service levels for every file type, rolled into an A–F grade.
Standards
Access is a permission, never a role name.
We do not hold, and do not claim, a third-party certification such as SOC 2 or HITRUST. What follows is what the platform enforces.
- Mandatory multi-factor authentication (authenticator app or phone), bot protection on sign-in, and trusted-device management. Invitation-only accounts; no public sign-up.
- Role decides what you may do; location assignment decides whose data you see; providers see only their own attributed panel. Enforced in the database on every table, not just in the interface.
- Every view of patient-level detail writes an access-log entry. Sign-ins, MFA events, and lockouts are recorded.
- An immutable history of every work event: assignment, start, completion, skip, reopen.
- Sessions time out after inactivity, with a hard 12-hour ceiling. Three failed sign-ins lock the account.
- Notifications never carry protected health information, and the platform enforces that rule rather than trusting it.
- Locked, fingerprinted MIPS snapshots so a filed position can be reproduced later.
- Each customer is provisioned its own instance: a separate database, with its own credentials, holding that customer's data alone. No shared tables, no cross-customer control plane.
- Documentation never displays customer data; screenshots come from a synthetic demonstration tenant.
- A HIPAA-compliant platform. Every client signs a combined business associate and confidentiality agreement before any data is exchanged.
Every number, explained.
Each figure has a reference page: what it counts, what changes it, when it is blank, and what it must not be confused with. The question mark on every screen opens the documentation for that screen and signs you in on the way.
Questions people actually ask Population health management, explained by the workYour own instance, configured, not coded.
Alara Population Health is available today as a SaaS subscription. Each organization runs in its own isolated instance. Onboarding is a configuration change: sources, file types, column mappings, locations, and roles. The first screens fill after the first full file delivery.