ClarityQX is a Software as a Service (SaaS), healthcare analytics platform.

It is designed to enable health plans and health systems to simplify the design, implementation and monitoring of alternative payment models such as bundled payments, AccountableCare Organizations and other at risk-arrangements. The user friendly interface enables business users to quickly access drill-down dashboards to support provider engagement and contract negotiation processes. We also deliver self-service business intelligence capabilities to enable data science professionals to perform their own unique analysis and reporting.

ClarityQx is a certified HCI3 Prometheus Analytics platform.


  • Increase the speed to market of value based products
  • Increase provider engagement and adoption of value based programs
  • Reduce value based payment program administration by 20-30%
  • Reduce medical costs through clinical transformation


Clinically Validated Episode of Care Definitions

Our standards-based, episode of care definition library is consistently updated enabling the continuous identification of episodes and their associated volume, costs and care variations.

Flexible Provider Attribution

Through our flexible provider attribution processes we can attribute individual physicians, practices and facilities to episodes of care to better understand their quality and cost performance.

Rapid Identification Of
Episode Relationships

Through our clinical methodology we automate the identification of clinically related episodes increasing the ability understand the complexity of consumer populations.

Streamline Episode
Budget Creation

Through our analytic processes we quickly determine the average episode cost and provide a detailed view into their associated clinical services.

Configurable Episode
Dashboards & Reports

The drill down dashboards and exportable reports are flexible and easily configured to meet the unique needs of healthcare organizations.

Configurable Episodes & Analytics

Our episode definitions and analytics are configurable, for example: episode triggers, age parameters, and look-back/look-forward periods can be modified to meet specific program needs.

Select an icon to learn more about the ClarityQX modules


Episode Configuration

The ClarityQX Episode Configuration Module enables health plans and health systems to increase the flexibility of their value based payment programs by providing the capabilities to modify episode definitions.

The configuration module enables the administration and modification of episode parameters such as: look-back & look-forward durations, age ranges, included services and much more. With these capabilities health plans and health systems can define their programs to meet their unique provider network and consumer population needs.


Simple Parameters

For basic episode configuration, episode parameters such as the age range and the pre and post episode durations can be configured.

Foundational Parameters

For more advanced episode configuration, the discrete diagnosis and services codes such as the episode trigger, diagnosis and procedural codes can be defined.

Quality Parameters

As part of our analytic process Potential Avoidable Complications (PACs) are identified as part of our quality parameters. The PAC information can be configured to be included or excluded within the episode definitions.


  • Reduce administrative costs associated to the management of episode definitions
  • Reduce the complexity associated to configuring episodes
  • Increase flexibility via easily modifiable episode parameters
  • Improve provider engagement and adoption of value based programs


National Data Resource

The ClarityQX National Data Source module provides health plans and health systems visibility into 100+ million unique, de-identified consumers.

This longitudinal data source contains over 2 billion+ claims, which is regularly updated. By utilizing this data source, health plans and providers can more easily create a Value-based Payment (VBP) strategy by providing insight into regional episode volumes, provider performance, care team options, competitive benchmarks and more.


De-identified Membership and Demographics

The information is de-identified at the consumer level but contains information such as age, gender and location of residence.

Provider Identification

Providers with in the information remain identified, which can be linked to other data sources via the providers' NPI key or probabilistic demographic matching.

Monthly Health Plan Enrollment Information

This information conveys characteristics of the plan and plan type which the consumer is enrolled.

Medical Claims Information

This information contains a set of the paid and denied claims for all types of medical coverage (e.g. institutional, physician and ancillary care provider claims.)

Prescription Drug Claims Information

For consumer with prescription benefit coverage, the information contains a set of filled script claims.

Lab Information

The information contains numeric laboratory data from automated lab systems.


  • Improves analysis processes and results through access to a robust longitudinal data source
  • Improves ability to understand provider network composition and identify potential service gaps
  • Quickly understand national and regional healthcare trends
  • Provides a data enrichment source to for incomplete data sources


Episodes of Care Library

ClarityQX offers one of the richest libraries of standardized episode of care definitions to health plans and health systems.

There are over 90+ definitions within the library, which is consistently updated. By providing standardized and clinically validated episode definitions, health plans and health systems improve their ability to quickly structure value-based payment programs.

This library of definitions is updated frequently and is clinical reviewed by our partners. Below is the list of episodes currently supported by ClarityQX.

  • Acute

  • Stroke
  • Upper Respiratory Infection
  • Pneumonia
  • Acute Myocardial Infarction
  • Hip/Pelvic Fracture
  • Chronic

  • Glaucoma
  • Allergic Rhinitis/Chronic Sinusitis
  • Asthma
  • Chronic Obstructive Pulmonary Disease
  • Coronary Artery Disease
  • Hypertension
  • Arrhythmia / Heart Block / Condn Dis
  • Heart Failure
  • Gastro-Esophageal Reflux Disease
  • Crohn's Disease
  • Ulcerative Colitis
  • Diverticulitis
  • Low Back Pain
  • Osteoarthritis
  • Diabetes
  • Bipolar Disorder
  • Substance Use Disorder
  • Schizophrenia
  • Depression & Anxiety
  • Trauma & Stressors Disorders
  • Other

  • Lung Cancer
  • Rectal Cancer
  • Colon Cancer
  • Breast Cancer
  • Prostate Cancer
  • Gynecological Cancers
  • Pregnancy
  • Newborn
  • Preventive Care
  • Procedural

  • Cataract Surgery
  • Tonsillectomy
  • Lung Resection
  • CABG, Valve Rep, Complex Heart Surg
  • Pacemaker / Defibrillator
  • Coronary Angioplasty
  • Upper GI Endoscopy
  • Colorectal Resection
  • Colonoscopy
  • Gall Bladder Surgery
  • Bariatric Surgery
  • Knee Arthroscopy
  • Hip Replacement & Hip Revision
  • Knee Replacement & Knee Revision
  • Lumbar Laminectomy
  • Shoulder Replacement
  • Breast Biopsy
  • Mastectomy
  • Prostatectomy
  • Transurethral Resection Prostate
  • Hysterectomy
  • Vaginal Delivery
  • C-Section
  • System Related Failure

  • Coma, Persistent Veg. State (SRF)
  • Meningitis / Encephalitis (SRF)
  • Delirium, Encephalopathy (SRF)
  • Healthcare Acquired Pneumonia
  • Respiratory Failure (SRF)
  • Aspiration Pneumonia (SRF)
  • Hypotension / Syncope (SRF)
  • Shock / Cardiac Arrest (SRF)
  • Deep Vein Throm/Pulm Embolism (SRF)
  • Fluid Electrolyte Imbalance (SRF)
  • Central Venous Catheter Infn (SRF)
  • Acute CHF / Pulm Edema (SRF)
  • Malignant Hypertension (SRF)
  • Arterial Thromboembolism (SRF)
  • GI Bleed (SRF)
  • C-Difficile Infection (SRF)
  • Intestinal Obstruction (SRF)
  • Hepatitis (SRF)
  • Pancreatitis (SRF)
  • Accidental Falls (SRF)
  • Decubitus Ulcer (SRF)
  • Dermatitis, Urticaria (SRF)
  • Cellulitis, Skin Infection (SRF)
  • Diabetes, Poor Control (SRF)
  • Nutritional Deficiency (SRF)
  • Catheter Associated UTIs (SRF)
  • Acute Renal Failure (SRF)
  • Urinary Tract Infection (SRF)
  • Transfusion Related Complications (SRF)
  • Sepsis (SRF)
  • MRSA, Drug Resistant Infections (SRF)
  • Infections (SRF)
  • Adverse effects of drugs (SRF)
  • Poisoning (SRF)
  • Complication of Implanted Device (SRF)
  • Complication Surgical Procedures (SRF)
  • Routine Sick Care (SRF)