BOSTON, Oct. 17, 2025 (GLOBE NEWSWIRE) -- Zus Health, the always-on data platform that unifies every patient record into a single, comprehensive view, today announced new capabilities for accurately capturing a patient’s burden of illness.

Zus’s new risk adjustment solution brings together a seamless point-of-care workflow, linkage to supporting clinical documentation, and AI-powered suspecting to surface actionable coding opportunities. These insights more accurately reflect patient complexity, helping care teams to prioritize outreach and direct resources toward the patients who need them most. Pilots showed that expert risk coders accepted 93% of suggestions, including both recapture and high-confidence suspect opportunities.

The new risk adjustment solution extends the workflows that care teams already use to prepare for patient visits. By being integrated into their existing tools, these risk and coding insights help clinicians use their chart prep and appointment more efficiently while keeping risk adjustment aligned with their treatment activities.

In programs with three leading value-based care organizations, including Homeward Health, Zus used AI for both suspecting and recapture to uncover hidden clinical complexity and close risk adjustment factor (RAF) gaps. The findings illustrate what’s possible when risk adjustment evolves from a back-office burden to a real-time data asset.

“Value-based care is supposed to adjust for what patients are really dealing with,” said Jonathan Bush, CEO and co-founder of Zus Health. “But too often, the diagnoses that drive cost and complexity get left out. Providers don’t have the resources to deliver. Patients get partial care. This pilot shows we can fix that. Give clinicians the right data at the right time, and you get better coding, fairer payment, and care that reflects the patient in front of you.”

Real World Impact

Participating value-based care organizations used Zus’s AI-powered risk adjustment solution to analyze structured and unstructured clinical data, including conditions, medications, labs, and PDF notes, to recapture and identify novel suspected hierarchical condition categories (HCCs) for their Medicare Advantage populations.

Across these pilots, Zus’s risk adjustment solution helped coders:

• Identify previously undetected HCC suspects in 72.5% of patients reviewed.
• Find 1.3 new high confidence suspect codes per patient, representing up to $2,070 per patient in newly recognized and reimbursable complexity.
• Accept 93% of high confidence suspects and recapture opportunities.
  

When data moves freely between systems, every job in healthcare works better. Partners like Homeward Health are already seeing that in practice.

“Zus has helped our teams move from manual chart-building to a data-driven, proactive approach to documentation. Within weeks, our providers were working from clearer clinical evidence, addressing more validated clinical gaps, and spending less time searching for information,” said Elise Depew, senior director, revenue cycle management and risk adjustment operations of Homeward Health.

These early results show how unified data keeps risk adjustment aligned with care itself — helping teams make faster, more confident decisions that match what’s actually happening with patients.

See It in Action at HLTH 2025

Zus will demo its risk adjustment solution at HLTH 2025, October 19–22 in Las Vegas. Company leaders will be available for demos and discussions at booth #1821, with a live session and Q&A at 1 p.m. Pacific Time on Tuesday, October 21. Can’t make the demo? Stop by the booth anytime or book a meeting with the Zus team.

Beyond Risk: Powering Every Job in Care

Risk adjustment is just one of the many jobs that Zus helps make faster and more effective. The Zus platform unifies fragmented data into an always-on, evidence-rich patient record that powers everything from onboarding and quality-measure reporting to medication adherence and transitions of care. By creating a single, trusted view of every patient, Zus helps care teams spend less time reconciling data and more time delivering care — making every clinical, operational, and financial workflow smarter.

About Zus Health
Zus Health makes healthcare move at information speed. The platform unifies scattered data into an always-on common patient record: a complete, real-time history of labs, diagnostics, medications, and encounters collected across multiple providers over the course of a patient’s life.

Zus delivers this data directly into the systems providers already use to make decisions. Accessible via APIs and embedded tools, it equips care teams with actionable insights at the point of care, helping improve outcomes and financial performance.

Founded in 2020 by Jonathan Bush, co-founder and former CEO of athenahealth, Zus Health serves more than 90 of the top healthcare organizations and payers in value-based care models including Evergreen, Eventus Whole Health, HarmonyCares and more. For more information, visit ZusHealth.com.

Media Contact
Marcie Waters, marcie@propllr.com