CareJourney: Use-Cases, Insights and Reviews | 2025 Cuspera

CareJourney Provider Intelligence helped a tech-forward health plan improve its member provider directory. The plan wanted to help Medicare Advantage members find top providers and lower care costs. ...CareJourney gave the plan cost and quality scores for providers. The plan used these scores to rank providers and build better networks. Over 100,000 members had a better search experience and gave positive feedback.
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CareJourney Market Intelligence helped a Midwest MSSP ACO find a $1.1M annual gap in their risk score benchmark. The ACO struggled to understand why their risk scores were lower than average. CareJou...rney used claims data to compare the ACO’s risk scores and coding practices to state and MSSP benchmarks. They found that heart failure was underreported due to low recapture rates. This led to missed care and lower financial benchmarks. With CareJourney, the ACO identified areas to improve coding and plans to use the tool for future audits.
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UpStream used CareJourney’s BCDA analytics to track provider cost and utilization trends in real time. They needed faster analytics for ACO REACH participants to support patients and align physician ...payments. CareJourney enriched weekly claims data, helping UpStream benchmark spend, track avoidable ER visits, and forecast risk scores. UpStream created weekly expenditure reports and closed monthly financials faster. Over 1,000 PCPs benefited from more timely insights and reduced care gaps.
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Transcarent used the CareJourney platform to give its 1.3 million members better healthcare choices. They needed strong data on provider quality and costs to help people pick the right care. CareJour...ney gave Transcarent detailed provider insights and easy data integration. This helped Transcarent offer flexible pricing, cut admin costs, and connect patients to top care centers. Transcarent also saved money by using one data partner for all their needs.
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CareJourney’s MSSP Financial Benchmarking helped an ACO enablement company with a national reach. The company needed to prioritize sales conversations with over 30 primary care practices before a key... CMS deadline. CareJourney provided data to identify practices with higher MSSP attribution and projected financial benefits. The company used these insights to expand into two new states and avoid groups with low volume or negative benchmarks. This allowed them to grow their ACO footprint and prepare for success in the Medicare Shared Savings Program.
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CareJourney platform helped an innovative physician enablement company with direct contracting. The company needed accurate beneficiary alignment estimates and better provider analytics. CareJourney ...provided tools for alignment estimation, provider benchmarking, and network planning. The platform supported network expansion and improved provider performance. The company manages over 250,000 lives using CareJourney's data and analytics.
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