How Do I Maximize Revenue From My Payer Contracts?

When it comes to understanding how your providers are compensated and how your practice measures productivity, RVUs (Relative Value Units ) sit at the heart of the conversation. Yet, for many organizations, RVUs remain a confusing, behind-the-scenes metric, one that directly impacts reimbursement, performance, and incentive opportunities. Let’s break down what RVUs really mean, why they matter, and how visibility into them can transform your revenue strategy. What Are RVUs? Relative Value Units were created to establish a standardized way to measure the value of medical services. Each CPT code is assigned an RVU value that reflects three key components: Work RVU (wRVU): The provider’s time, skill, and intensity. Practice Expense RVU (peRVU): The overhead costs of delivering the service. Malpractice RVU (mRVU): The cost associated with liability coverage. When multiplied by the Medicare conversion factor , these RVUs determine the reimbursement rate for each service. In short: RVUs translate effort into earnings. Why RVUs Matter for Your Practice RVUs aren’t just a benchmark for reimbursement, they’re a reflection of your operational efficiency and clinical output. When tracked effectively, RVUs can: Reveal provider productivity trends and workload balance. Identify underperforming codes or services that might be undervalued or underutilized. Drive fair and transparent compensation models. Support contract negotiations by highlighting true service value. Without accurate RVU data, practices risk leaving significant revenue unclaimed, or worse, making business decisions on incomplete information. Turning RVUs Into Actionable Insight This is where Adageis steps in. Our platform doesn’t just report RVUs, it helps you understand and optimize them. By combining real-time payer data, contract visibility, and performance analytics, Adageis helps practices: Identify discrepancies between billed and reimbursed services Track RVU-based incentive performance Uncover missed opportunities tied to coding or quality measures With data that’s never more than 24 hours old, your team can make confident, informed decisions every day. ________________________________________ See Your RVUs in a New Light RVUs shouldn’t be a mystery, they should be a roadmap to growth. Adageis gives you the clarity to measure productivity, align incentives, and ensure every service is valued exactly as it should be.

The push toward value-based care has promised better outcomes for patients and fairer rewards for providers, but the reality has been anything but simple. Doctors are juggling hundreds of insurance plans, countless electronic health record systems, and constantly shifting performance measures, all while trying to give patients the attention they deserve. To better understand these challenges and how technology can ease them, we sat down with Dr. Shane Speirs, CEO and Founder of Adageis. Drawing on his own experiences as a practicing physician, Dr. Speirs shares the inspiration behind Adageis, the hurdles faced in its early days, and his vision for how automation can empower providers to succeed in value-based care. Q: What was happening in healthcare or in your own career that sparked the idea for Adageis? Value-based care was a great idea. At its core, it’s about providing high-quality care to patients, focusing on meaningful medical care rather than just seeing as many patients as possible. In a perfect world, that’s easy to support. In the real world, it’s far more complicated. In Phoenix alone, we have over 100 insurance companies offering more than a thousand different health plans. Each plan has different quality measures and different documentation requirements. When I was working in a clinic, I’d sit with a stack of PDFs trying to figure out which measures applied to which patient. For example, Jane Doe with Blue Cross Blue Shield required one set of measures, while John Smith with Aetna required another. Trying to do that in a 15-minute visit while diagnosing, treating, prescribing, and documenting, is impossible . That’s why we created Adageis: to make the transition to value-based care easy for everyone, whether you’re a large health system or an independent physician. Q: What was the biggest challenge you faced in the early days of building Adageis? I’d say there were two big challenges. First, working with electronic health record (EHR) systems. There are over 90 EHR systems we integrate with, all with different connections, costs, and technical barriers. Despite regulations saying data should be shared, in practice it’s difficult and expensive. Overcoming that was a huge hurdle. Second, working with practices themselves. Some physicians were already doing everything they could to succeed under value-based care. Others were still stuck in the old productivity model, seeing 50 patients a day just to maximize volume. Helping those practices transition was and still is a challenge. The good news is that the environment is changing. Up until three or four years ago, you could get away with the old model. But now, CMS is cutting payments on the fee-for-service side while rewarding providers two to three times more under value-based care. Practices that ignored value-based care before are now actively looking for solutions, and that’s where Adageis steps in. Q: Was there a key moment when you realized Adageis could change the way providers work? Yes. We had been developing the platform for years, but when I started using our beta product in my own clinic, that was the turning point. I immediately saw how much easier it became to provide high-quality care—and to be fairly rewarded for it. That was when I knew this was a game changer. Q: Some providers feel like chasing incentives takes away from patient care. How do you view that balance? I understand that feeling. But the truth is, if you’re providing great care—controlling chronic conditions, keeping patients proactive with screenings, managing diabetes and hypertension—you should be rewarded. No physician should feel shame for wanting to provide for their family while also giving patients the best possible care. That’s what value-based care is meant to align: the goals of patients, providers, and payers. Q: How has the original vision for Adageis evolved into what it is today? The original vision was simple: help providers transition to value-based care more easily. We built a solution that tells providers exactly which measures apply to each patient and how to document them. Today, we’re going even further with automation. Our AI scribe listens to patient encounters, creates clinical notes, suggests diagnosis and procedure codes, and will soon auto-document directly in the EMR. Adageis messaging creates automated care campaigns calculated against your EHR patient data and your contractual payer contracts. It allows templated texts to be sent on queue, prompting patients to get the care they need. That’s the future we’re building toward: making healthcare easier for everyone while reducing the burden on providers.

Before Adageis: In Q1 of 2024, Dr. C’s practice was struggling to capture value from quality incentive programs. Despite delivering excellent patient care, he was only realizing 10–20% of available Quality Incentive Payments. By the end of March, this translated into less than $4,000 in revenue—a fraction of what was on the table. This is a challenge we see across the board: clinicians are busy, EHRs aren’t built to surface revenue opportunities, and incentive program rules are far too complex to track manually. As a result, providers like Dr. C consistently miss out on money they’ve already earned. With Adageis in 2025: Fast forward one year. With Adageis in place, Dr. C’s practice is now able to identify and act on incentive opportunities in real time. By Q1 of 2025, he was already realizing 20–30% of available Quality Incentive Payments—a nearly $70,000 increase in the first quarter alone. And the momentum doesn’t stop there. By year end, Dr. C is on track to recognize nearly $200,000 in incentive pay. What Changed? Adageis transformed Dr. C’s incentive revenue by: Surfacing real-time care gap opportunities directly in the workflow. Translating payer contracts into actionable insights at the point of care. Eliminating guesswork for his team, ensuring no incentive dollars are left behind. Instead of trying to retroactively chase metrics, Dr. C’s team can focus on patient care—knowing Adageis is guiding them to meet quality targets and unlock hidden revenue. The Takeaway: Dr. C’s story is proof that the right tools can bridge the gap between excellent care and financial performance. Without adding new staff or extra hours, his practice went from leaving 80–90% of incentive revenue on the table to confidently maximizing payments—projected to earn an additional $200,000 this year.

Adageis is excited to announce the successful closure of our $2 million Seed round at the end of Q4 2024. This milestone marks a significant step forward in our mission to revolutionize healthcare technology and streamline operations for providers across the industry. Investing in the Future With this funding, we are strategically focusing on three key areas to drive growth and enhance our platform: 1. Upgrading Our Backend Infrastructure To better support the next generation of healthcare technology, we are investing in major backend improvements. These upgrades will enhance the scalability, speed, and reliability of our system, ensuring a seamless user experience for healthcare providers and administrators alike. 2. Expanding Our Sales Force To accelerate adoption and reach a broader audience, we are expanding our sales team. This investment will allow us to deploy rapid growth strategies, engage with more healthcare organizations, and demonstrate the value of Adageis’ solutions to providers looking to maximize efficiency and revenue. 3. Enhancing Connectivity with EHR Systems One of our top priorities is improving interoperability. We are enhancing our system’s connectivity to integrate with over 90 different Electronic Health Record (EHR) systems. This will enable faster deployment and smoother integration for healthcare providers, ensuring they can seamlessly adopt and benefit from our platform. Looking Ahead The closing of our Seed round is just the beginning. As we continue to scale, our focus remains on delivering innovative solutions that empower healthcare professionals, optimize workflows, and improve patient care. We are excited for what’s ahead and look forward to sharing more updates as we advance on this journey. Stay tuned for more developments, and thank you to our investors, partners, and customers for your continued support!

In recent years, physician burnout has become a pressing concern in healthcare. With growing administrative burdens, particularly around documentation, many healthcare providers find themselves spending more time typing notes than caring for their patients. The result? Rising levels of stress, job dissatisfaction, and ultimately, burnout. But now, artificial intelligence (AI) offers a solution that can help The Burnout Crisis in Healthcare A 2023 Medscape survey revealed that 53% of physicians reported feelings of burnout , citing excessive administrative work as one of the leading causes. Healthcare professionals are spending an average of 16 minutes per patient completing electronic health records (EHRs), which can add up to several hours of documentation per day. For physicians who entered the field to provide compassionate care, this relentless data entry detracts from their core mission. The result is a growing number of providers feeling overwhelmed, emotionally drained, and distanced from their patients. Enter AI Scribe: The AI-Powered Solution AI technologies, like Adageis' new AI Scribe, are changing the game. By using advanced algorithms to assist in real-time note-taking and documentation, AI Scribe can drastically reduce the time physicians spend on charting. With an average note completion time of just 2 minutes, providers can refocus their energy where it matters most—on delivering quality care. By automating documentation tasks, AI Scribe doesn’t just save time—it also helps reduce the mental load of managing paperwork. Physicians no longer have to worry about facing hours of backlogged notes at the end of their day. Instead, AI Scribe works as a virtual assistant, capturing key information and structuring notes in the background, allowing providers to maintain eye contact and engage more meaningfully with their patients. AI as a Burnout Fighter The impact of tools like AI Scribe extends beyond just time savings. When physicians feel less overwhelmed by administrative tasks, they are less likely to experience burnout. They can focus on what they were trained to do—diagnose, treat, and connect with patients. This shift is crucial in an industry where human interaction and patient trust are essential to successful care. Physicians who have integrated AI into their practice have reported feeling a renewed sense of purpose and satisfaction. Being able to hand over repetitive tasks like note-taking frees them to concentrate on clinical decision-making and patient care. The Future of AI in Healthcare While AI isn’t a magic cure for all the challenges in healthcare, it is a powerful tool that can mitigate one of the most significant contributors to physician burnout: documentation overload. As AI continues to evolve, its role in supporting physicians will only grow, offering new ways to streamline workflows, enhance patient care, and protect the well-being of healthcare professionals. At Adageis, we believe that by empowering healthcare providers with innovative technology like AI Scribe, we can bring back the joy of practicing medicine. Physicians deserve tools that support—not hinder—their ability to provide care. With AI, we’re not just typing less; we’re caring more. ________________________________________ Ready to discover how AI Scribe can reduce burnout and improve your practice? Learn more and schedule a demo today

The shift towards value-based care has placed a premium on quality incentives. These incentives are designed to reward healthcare providers for delivering high-quality care, improving patient outcomes, and reducing costs. However, achieving and maximizing these incentives requires more than just good intentions—it demands a strategic approach rooted in data-driven decision-making. This is where data analytics comes into play. The Power of Data-Driven Decision-Making in Healthcare Data analytics has revolutionized various industries, and healthcare is no exception. In a field where decisions directly impact patient lives, the ability to harness and interpret vast amounts of data is invaluable. By leveraging data analytics, healthcare providers can: Identify Trends and Patterns: Data analytics enables the identification of trends and patterns in patient outcomes, treatment effectiveness, and operational efficiency. These insights allow providers to pinpoint areas for improvement, ensuring that resources are allocated where they can have the most significant impact. Predict Outcomes: Predictive analytics can forecast patient outcomes based on historical data, allowing healthcare providers to intervene proactively. For instance, by identifying patients at risk of readmission, providers can implement targeted interventions to prevent it, thereby improving quality scores. Optimize Resource Allocation: Efficient resource allocation is crucial in healthcare, where both human and financial resources are often limited. Data analytics can help optimize the use of these resources by identifying which areas require more attention and which practices yield the best results. Optimizing Quality Incentive Programs with Data Analytics Quality incentive programs, such as those under the Medicare Quality Payment Program (QPP), are designed to promote value-based care by rewarding providers who deliver high-quality care. However, these programs are complex, with numerous metrics and benchmarks to meet. This complexity can make it challenging for healthcare providers to fully capitalize on the incentives available to them. Our platform addresses this challenge by integrating advanced data analytics into the management of quality incentive programs. Here's how: Real-Time Performance Monitoring: Our platform provides real-time insights into performance across various quality metrics. By continuously monitoring these metrics, providers can make data-driven decisions to improve their performance, ensuring they meet or exceed the benchmarks required for maximum incentives. Digitizing your Contracts: We upload all your incentive rules into our AI-powered engine. Follow the Dollar: Included in the platform is your incentive reimbursement to help you see potential. Track where your revenue is coming from and identify areas where you could potentially increase earnings. The Future of Data Analytics in Healthcare As the healthcare industry continues to embrace value-based care, the role of data analytics will only grow. Future advancements in artificial intelligence and machine learning promise to enhance the capabilities of data analytics even further, enabling more precise predictions, deeper insights, and more effective interventions. For healthcare providers, the ability to harness these tools is essential for staying competitive and maximizing quality incentives. Our platform is at the forefront of this movement, providing the analytics-driven insights needed to thrive in an increasingly data-driven healthcare environment. Data analytics is a necessity in healthcare today. By making data-driven decisions, healthcare providers can ensure they are delivering the highest quality care while also maximizing their financial rewards. Our ProActive platform is designed to empower providers with the insights they need to achieve these goals, positioning them for success in the era of value-based care.

The healthc are industry in the United States is undergoing a significant transformation as it continues its shift towards value-based care. This model, which emphasizes quality and outcomes over the volume of services provided, is designed to improve patient care while reducing costs. However, as promising as value-based care is, it comes with its own set of challenges that are placing financial pressure on healthcare providers. The Complex Landscape of Value-Based Care Value-based care is a critical focus for healthcare providers, but its implementation is far from straightforward. Several factors contribute to the complexity: 1. Physician Shortages: The U.S. is currently facing a shortage of physicians, which is projected to worsen in the coming years. This shortage puts additional strain on healthcare providers, who are already tasked with delivering high-quality care while managing a growing patient population. With fewer doctors available, maintaining the quality of care required under value-based care models becomes increasingly difficult. 2. Inefficiencies in Government Payer Systems: Government payers, such as Medicare and Medicaid, are integral to the value-based care framework. However, inefficiencies within these systems, including delayed payments and complex reimbursement processes, can hinder providers' ability to operate effectively. These challenges can lead to cash flow issues, making it harder for providers to invest in the resources necessary to succeed in a value-based care environment. 3. Dominance of Medicare Advantage: Medicare Advantage plans, which offer an alternative to traditional Medicare, have gained significant traction in the U.S. market. While these plans are a key component of the value-based care model, they also introduce additional layers of complexity. Providers must navigate varying reimbursement rates and performance metrics, which can add to the financial pressures they face. Balancing Quality and Costs with AI As healthcare providers grapple with these challenges, the need for innovative solutions has never been greater. One such solution is the integration of advanced technologies, such as artificial intelligence (AI), into healthcare operations. Our platform's Patented AI Risk Engine is designed to help providers manage the dual pressures of improving quality and controlling costs. Here’s how: • Predictive Analytics for Patient Outcomes: The AI risk engine uses predictive analytics to forecast patient outcomes, allowing providers to identify at-risk patients early and intervene before costly complications arise. By proactively managing patient health, providers can reduce unnecessary hospitalizations and improve their performance on key quality metrics. • Optimized Resource Allocation: AI can analyze vast amounts of data to identify inefficiencies in care delivery. By optimizing resource allocation, providers can ensure that they are delivering the right care at the right time, reducing waste and improving patient outcomes. • Streamlined Reimbursement Processes: The AI risk engine can also assist in navigating the complex reimbursement landscape by automating claims submissions and ensuring that providers meet the specific requirements of different payer systems. This reduces the administrative burden on healthcare providers and ensures faster, more accurate reimbursements. The Path Forward As value-based care becomes increasingly prevalent, healthcare providers must find ways to balance the demands of improving quality with the need to manage costs. The integration of AI-driven technologies, such as our Patented AI Risk Engine, offers a promising path forward. By leveraging these tools, providers can not only survive but thrive in a value-based care environment, ensuring that they deliver the highest quality care to their patients while maintaining financial stability. While the shift towards value-based care presents significant challenges, it also offers opportunities for innovation and improvement. Healthcare providers who embrace AI and other advanced technologies will be better equipped to navigate the complexities of this new landscape, ultimately leading to better outcomes for both patients and providers.

Women's health encompasses a wide range of care, from reproductive care to managing and preventing chronic illnesses. With our heavy loads of daily responsibilities, it's easy to neglect our health. However, prioritizing regular health screenings is one of the most important steps we can take for our long-term well-being. Understanding Women's Health Women’s health is unique and requires specialized surveillance. From puberty to menopause, women experience a range of hormonal changes that can impact overall health. Women are also at risk for specific health issues, such as breast and cervical cancer, osteoporosis, and reproductive health problems. Regular screenings are designed to monitor these unique aspects of women's health, ensuring early detection and intervention. Important Screenings for Women Breast Cancer Screening (Mammogram) Why It's Important: Breast cancer is one of the most common cancers among women. A mammogram can detect tumors that are too small to be felt, significantly improving the chances of successful treatment. Cervical Cancer Screening (Pap Smear and HPV Test) Why It's Important: Cervical cancer can often be prevented through early detection of precancerous changes. Regular Pap smears and HPV tests are crucial in catching these changes early. Bone Density Test (DEXA Scan) Why It's Important: Women are at higher risk for osteoporosis, especially after menopause. A DEXA scan measures bone density and can help prevent fractures by identifying early bone loss. Blood Pressure and Cholesterol Screening Why It's Important: Heart disease is a leading cause of death among women. Regular screenings for blood pressure and cholesterol levels help in managing heart health and preventing heart disease. Diabetes Screening Why It's Important: Type 2 diabetes is a growing concern, and women with a family history or other risk factors should be particularly vigilant. Early detection can prevent serious complications. Mental Health Screenings Why It's Important: Mental health is a crucial component of overall well-being. Screenings for depression, anxiety, and other mental health conditions can lead to timely support and treatment. Taking Charge of Your Health Our health is our most valuable asset. Regular health screenings are not just about detecting diseases; they’re about taking charge of our well-being. They provide a sense of empowerment, knowing that we are proactively managing our health. Women's health screenings offer early detection, preventive care, and peace of mind. Schedule your screenings, stay informed, and take control of your health. Remember, you are worth the time and effort it takes to ensure your health. Make that appointment today—because your health matters. Adageis is partnered with Ma’am Exams to support them in providing exceptional woman’s healthcare services to women in our community. Together, we’re committed to helping pr ovide proactive he althcare.

In today's healthcare, two primary approaches dominate the conversation: proactive healthcare and reactive healthcare. Understanding the distinction between these approaches and recognizing the benefits of proactive healthcare can significantly impact personal well-being and societal health outcomes. Proactive Healthcare: Prevention is Better than Cure Proactive healthcare emphasizes the prevention of illness and the promotion of overall well-being. This approach involves regular check-ups, screenings, vaccinations, and lifestyle modifications to prevent diseases before they occur. The key components of proactive healthcare include: Routine Screenings and Check-ups: Regular medical check-ups and screenings help detect potential health issues early, allowing for timely intervention. Early detection of conditions like hypertension, diabetes, and cancer can significantly improve treatment outcomes and reduce the risk of complications. Vaccinations: Immunizations protect individuals from various infectious diseases, reducing the prevalence and spread of illnesses within communities. Vaccines are a cornerstone of preventive medicine, safeguarding both individual and public health. Healthy Lifestyle Choices: Encouraging healthy habits such as balanced nutrition, regular physical activity, adequate sleep, and stress management can prevent chronic diseases and enhance overall quality of life. Lifestyle modifications play a crucial role in mitigating risk factors associated with heart disease, obesity, and mental health disorders. Education and Awareness: Providing individuals with knowledge about health risks and preventive measures empowers them to make informed decisions. Health education campaigns and community programs can raise awareness about the importance of proactive healthcare practices. Reactive Healthcare: Responding to Illness Reactive healthcare, in contrast, focuses on treating diseases and health conditions after they have developed. This approach involves diagnosing and managing illnesses through medical interventions, such as medications, surgeries, and therapies. While reactive healthcare is essential for addressing acute and chronic conditions, it often comes with higher costs and increased strain on healthcare systems. The Benefits of Proactive Healthcare Cost-Effectiveness: Preventive measures are generally more cost-effective than treating advanced diseases. Regular screenings and vaccinations can reduce the need for expensive treatments and hospitalizations, leading to significant healthcare savings for individuals and society. Improved Health Outcomes: Early detection and intervention can lead to better health outcomes. For instance, cancers diagnosed at an early stage are often more treatable and have higher survival rates compared to those detected at later stages. Proactive healthcare helps in managing chronic conditions more effectively, reducing the risk of complications and improving quality of life. Reduced Healthcare Burden: By preventing diseases and promoting overall well-being, proactive healthcare can alleviate the burden on healthcare systems. Fewer hospitalizations and medical interventions translate to reduced strain on healthcare resources, allowing for more efficient and equitable distribution of care. Enhanced Quality of Life: Proactive healthcare empowers individuals to take charge of their health, leading to enhanced physical, mental, and emotional well-being. A healthy lifestyle and preventive measures contribute to increased energy levels, better mood, and improved overall quality of life. Public Health Benefits: Widespread adoption of proactive healthcare practices can lead to healthier communities and reduced transmission of infectious diseases. Herd immunity through vaccinations, for example, protects vulnerable populations and contributes to the overall health of society. By prioritizing prevention, early detection, and healthy lifestyle choices, we can improve individual and public health outcomes, reduce healthcare costs, and enhance overall quality of life. Embracing proactive healthcare empowers us to take control of our well-being and fosters a culture of health and wellness for generations to come.