Driven by Data.
Inspired by Outcomes.

Driven by Data.
Inspired by Outcomes.


By partnering with Tessellate, you will benefit from industry-leading solutions that deliver proven results. Our risk adjustment and quality programs bring together every piece of the puzzle to increase revenue and improve quality of care. We offer end-to-end solutions that are provider-centric, low abrasion and can be quickly implemented. Tessellate’s experience working with Medicare Advantage and Commercial plans, driving effective provider engagement, and supporting strategic initiatives in risk adjustment and quality will provide solutions that achieve your goals and deliver value beyond the numbers.

The average health plan likely documents and reports less than 60 percent of the chronic conditions of its members. Tessellate improves risk scores and simultaneously reduces RADV audit risk while boosting Star Ratings.

Watch more on how we can help you


Tessellate brings you the most innovative and versatile solutions in the industry. You can increase the accuracy and completeness of clinical condition documentation, improve risk scores and drive quality improvement for Stars with help from Tessellate.

  • Serves over 1 million Medicare Advantage and Commercial members
  • Operates in over 20 states and Puerto Rico
  • Manages over $5 billion in risk adjustment-related revenue
  • Delivers over $300 million in quality-related bonus revenue
  • Has achieved a 4-Star Rating for a national PPO plan the past four years

Provider Engagement Coordination

A differentiated prospective program. Between our on-site Provider Engagement Coordinators (PECs) and our proprietary process, this program focuses on assisting providers with complete and accurate documentation with minimal abrasion.

  • Provider-centric prospective program
  • Increases risk scores an average of +.200 in 24 months
  • Improves clinical Star measures an average of 5 percent
  • 1- to 3-month implementation timeline
  • In-market resources
  • Technology enablement

Risk Adjustment

A true end-to-end risk adjustment solution. Our program has unique comprehensive capabilities and a fully integrated approach. While most efficient as a combined package, all risk adjustment solutions are available as point solutions. We dive deep into member profiles, provider performance and condition-specific analysis to deliver superior outcomes. The solution includes:

  • CMS bid optimization and benefit design
  • Projections, modeling and reporting
  • Retrospective services
  • RAPS/EDPS data submissions
  • RADV audit support

Quality Improvement

A partner with years of demonstrated success in Stars and HEDIS. We offer an end-to-end integrated and tailored solution that delivers improved Star Ratings and HEDIS scores through proven strategic initiatives. We leverage our unique health plan knowledge and clinical expertise to create an innovative offering that delivers 4-Star program performance.

The purpose behind our passion.

Helping people live longer, healthier lives.

Contact Tessellate
Join us at RISE | March 6–8, 2017

We are proud to announce our Platinum sponsorship at the Medicare Advantage industry’s premiere event. During the conference, we will be available to speak with you one-on-one to discuss your needs and the benefits of partnering with Tessellate.

Make your appointment now