Medicare Advantage organizations struggle to identify coding opportunities, suspect conditions, RAF optimization opportunities, and risk adjustment revenue improvement opportunities across large member populations.
Medicare Advantage organizations struggle to identify coding opportunities, suspect conditions, RAF optimization opportunities, and risk adjustment revenue improvement opportunities across large member populations.
Medicare Advantage Plans, Risk Adjustment Vendors, Healthcare Analytics Organizations, Consulting Firms
Medicare Advantage Risk Adjustment Dataset (MARAD) is built around high-value intelligence areas that support clearer decisions, stronger prioritization, and better operational visibility.
Identify hierarchical condition category opportunities, suspected conditions, and coding gaps across Medicare Advantage populations.
Estimate RAF opportunity and financial impact from documented, suspected, and missing condition signals.
Support end-to-end MA risk adjustment analytics including member risk stratification, coding opportunity, and documentation improvement.
Flag diagnosis, encounter, and documentation patterns that indicate potential coding review opportunities.
Surface member-level suspected conditions that may require chart review, provider query, or clinical validation.
Connect risk adjustment signals to chronic disease burden, member risk, and care management opportunity.
Use clinical, diagnosis, utilization, and documentation indicators to support risk and coding decisions.
Analyze chronic disease patterns and recapture opportunities across high-risk MA populations.
Prioritize members by risk score, gap value, condition burden, and potential clinical or financial impact.
Connect risk adjustment opportunity with quality, care gap, and population health priorities.
Quantify financial opportunity from HCC gaps, RAF movement, and risk adjustment improvement.
Estimate member RAF opportunity and identify where coding or documentation interventions may create value.
Forecast likely risk adjustment opportunity using member, claim, diagnosis, and clinical pattern indicators.
Translate coding and RAF opportunities into estimated revenue impact and prioritization value.
Medicare Advantage Risk Adjustment Dataset (MARAD) is built for organizations that need practical intelligence, stronger prioritization, and business-ready analytical outputs.
Identify RAF opportunity, suspect conditions, and documentation gaps across MA membership.
Prioritize members, charts, and conditions based on expected financial and clinical value.
Support coding review, HCC capture, recapture activity, and provider query prioritization.
Improve clinical specificity and documentation completeness for risk adjustment programs.
Embed risk adjustment scoring, HCC gap detection, and RAF opportunity analytics into client solutions.
Use this dataset to move from raw records to prioritized opportunities, clearer decisions, and measurable business value.
Estimate financial opportunity from risk score movement and unresolved condition evidence.
Surface open HCC opportunities and potential recapture gaps across member populations.
Prioritize conditions and members most likely to justify review or provider engagement.
Connect risk opportunities to documentation completeness and clinical specificity issues.
Support more defensible risk adjustment operations through structured analytics.
Download the sample package to inspect the record structure, field layout, documentation quality, and sample intelligence before selecting a license.
Risk adjustment performance can materially influence Medicare Advantage reimbursement and audit readiness. Medicare Advantage Risk Adjustment Dataset (MARAD) is designed to help Risk Adjustment, CDI, and analytics leaders identify HCC, RAF, suspect condition, documentation, and member-prioritization opportunities.
All licenses include the same field structure, documentation package, and data dictionary. The primary difference is record volume and redistribution rights.
| Feature | Developer | Professional | Enterprise | OEM |
|---|---|---|---|---|
| Records Included | Up to 25,000 | Up to 250,000 | Full Dataset | Full Dataset |
| Fields Included | All | All | All | All |
| Documentation | Yes | Yes | Yes | Yes |
| Internal Use | Yes | Yes | Yes | Yes |
| Redistribution Rights | No | No | No | Yes |
| Product Embedding Rights | No | No | No | Yes |
Choose the license that matches your intended use.
Includes:
• Up to 25,000 records
• Single user
• CSV format
• Data dictionary
• User guide, buyer guide, and product sheet
• Commercial use for individual analytics
Includes:
• Up to 250,000 records
• Up to 25 users
• CSV format
• Data dictionary, schema, and metadata
• User guide, buyer guide, and product sheet
• Department or team analytics use
Includes:
• Full dataset
• All records included
• Unlimited internal users
• CSV + Parquet when included
• Full documentation package
• Quality and certification materials when included
Includes:
• Full dataset
• Unlimited users
• Commercial embedding rights
• Resale and redistribution rights
• White-label use rights
• OEM documentation package
Same-Day Purchase of Dataset Required
The Executive Dashboard Intelligence Pack is designed only for the corresponding Medicare Advantage Risk Adjustment Dataset (MARAD). It is not a standalone dashboard product and requires the same-day purchase of the matching Intelligence Dataset license.
Includes:
• 10 executive KPI dashboards
• Executive KPI library
• Opportunity scoring models
• Financial impact analysis
• Operational intelligence framework
• Excel dashboard workbook
• Power BI implementation package
• Tableau implementation package
• Data dictionary and field mapping guide
Price: $4,999 add-on
Buy Dashboard PackSame-day purchase of a dataset license will be verified and the matching Executive Dashboard Intelligence Pack for this dataset will be sent.
The Medical Audit & Recovery Analytics Dataset is positioned as an executive operational intelligence asset, not a static data file. It helps leadership teams understand what is happening, quantify the opportunity, compare performance, prioritize action, and move from insight to measurable operational improvement.
Medical audit programs frequently lack integrated intelligence for audit targeting, recovery prioritization, documentation review, and financial impact tracking.
Financial exposure includes missed recovery, poor audit yield, avoidable overpayments, inefficient audit selection, and unmanaged compliance risk.
Executives need a clear operating view of the business problem, the operational drivers behind the issue, the financial exposure, and the specific improvement actions most likely to create measurable results. This dataset supports that view by organizing domain-specific signals into executive-ready intelligence.
The dataset supports benchmark comparisons across internal performance history, operating units, peer groups, transformation targets, industry norms, and executive performance thresholds. Leaders can use the benchmark layer to identify gaps, quantify variance, and select the highest-value improvement priorities.
Medical Audit & Recovery Executive Dashboard Intelligence Pack converts the dataset into executive decision support with KPI intelligence, benchmark analytics, opportunity scoring, operational prioritization, financial impact visibility, governance reporting, and executive reporting.
Medical Audit & Recovery Healthcare Operational Improvement Program converts insight into action through a structured improvement roadmap, project portfolio, governance framework, benefits realization model, and executive business case.
Healthcare Operational Intelligence Playbook™ → Intelligence Dataset → Executive Dashboard Intelligence Pack → Healthcare Operational Improvement Program → HDIP → Continuous Operational Transformation.
This path positions MARAD as part of a complete transformation journey rather than a standalone file purchase.
CFO, Payment Integrity, Audit Leadership, Compliance, Revenue Integrity, Health Plan Operations