Clinigence

What Clinigence does

Clinigence Health is a SaaS healthcare analytics company that operates a cloud-based population health and value-based care platform. The platform aggregates clinical data (EHR, CCDa, QRDA CAT 1), claims feeds, HIE, labs, pharmacy, and SDOH data into unified patient and provider views, then layers predictive risk stratification using the Johns Hopkins ACG System and HCC Risk Logic alongside quality measure reporting. Its core product surface — delivered through the QMX (Quality Management Xchange) platform powered by AWS QuickSight — comprises modules for patient/member metrics, quality improvement, cost and utilization, risk prediction, provider network optimization, custom analytics, and commercial CQM/gaps-in-care workflows. As of 2024, the platform covered 5.869 million patients across 118 organizations, 20,791 practices, 21,131 providers, and 24 payer organizations.

The company sells primarily to US-based health plans, provider organizations, ACOs (including MSSP and ACO REACH), and third-party administrators via a direct enterprise field sales motion, supplemented by NAACOS and HIMSS conference presence. Revenue is generated through annual SaaS subscriptions priced on organization size (provider counts, patient lives) and number of quality measures, plus one-time implementation fees tied to data source integration. The platform holds ONC CEHRT certification (Health IT Module, 2015 Edition), is a CMS Qualified Registry, and supports over 200 CMS eCQMs and CQMs along with commercial measures.

Clinigence Health has been reshaped by a series of corporate transactions: founded circa 2013, it acquired ProCare Health (MSO) in October 2021, merged with Nutex Health in April 2022 (the combined entity listed on NASDAQ as NUTX with Clinigence Health as a wholly-owned subsidiary), and was acquired by AssureCare in September 2024. Post-acquisition, Clinigence Health operates within AssureCare's Akumen brand, aligning its provider/risk-bearing-entity analytics capability with AssureCare's payer-centric MedCompass platform.

Name

Clinigence

Legal name

Clinigence Holdings, Inc.

Website

https://clinigencehealth.com

Company type

Private

Founded year

2010

Operating status

Acquired

Headcount range

11–50 employees

Short description

Clinigence Health is a SaaS healthcare analytics company providing population health management, value-based care reporting, and risk stratification to US health plans, ACOs, provider organizations, and TPAs via its AWS-powered QMX platform.

Ownership category

akta.pro rank

Headquarters

HQ city

Atlanta

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Marketing or Sales, Operations, Infrastructure

Revenue model

1. SaaS Subscription - Clinical Quality Measures Analytics: Annual software-as-a-service (SaaS) contract for clinical quality measure (CQM) analytics, including recording, calculating, and reporting. Service allows healthcare providers to aggregate patient data from various sources including EHR systems, track performance at organization, practice, and individual provider level in near real-time, and report to different outside agencies. Service costs are based on organization size (number of providers, patients, etc.) and number of CQMs, charged on a periodical basis (annual, monthly). One-time setup fees may apply based on number and type of data sources.
2. One-Time Setup/Implementation Services: One-time setup fees charged based on the number and type of data sources integrated. Implementation team handles configuration and deployment of CQMs and custom measures using proprietary configuration methodology.

Pricing tiers

Go-to-market motion2 records

Distribution channels2 records

Marketing channels6 records

Core offering

Clinigence Health provides a cloud-based SaaS healthcare analytics platform (QMX) that aggregates clinical (EHR), claims, pharmacy, HIE, lab, and SDOH data to deliver population health management, predictive risk stratification, MIPS/eCQM/CQM quality reporting, provider network optimization, and value-based care analytics for health plans, provider organizations, ACOs, and TPAs. The platform is powered by AWS infrastructure, Amazon QuickSight, the Johns Hopkins ACG System, and HCC Risk Logic, with integrated AI/ML/NLP and generative AI reporting capabilities.

Product overview

Clinigence Health offers a cloud-based healthcare analytics platform primarily delivered as the QMX (Quality Management Xchange) product — a unified SaaS solution with integrated modules including Patient & Member Metrics, Quality Improvement, Cost & Utilization Analytics, Predict & Mitigate Risk, Custom Analytics & Reporting, Monitor & Report Quality Measures, Population Health Management, Provider Network Optimization, and Commercial CQMs & Gaps in Care. The platform aggregates clinical and claims data to provide transparency on quality indicators and outcomes across health plans, provider organizations, and third-party administrators. As of September 2024, Clinigence Health was acquired by AssureCare and now operates under the Akumen brand.

Differentiator

Problem solved

Functional benefit

Brands

• QMX: Advanced business intelligent software solution powered by AWS that turns data into useful insights for value-based care through generative AI.
• Akumen

Products and services

• QMX (Quality Management Xchange) Cloud-based business intelligence platform powered by AWS and Amazon QuickSight that aggregates clinical, claims, pharmacy, HIE, lab, and SDOH data into interactive, customizable dashboards and reports. Provides generative AI-powered reporting, predictive risk stratification using Johns Hopkins ACG System, quality measure tracking (MIPS/eCQM/CQM), provider network optimization, and value-based care analytics for health plans, ACOs, provider organizations, and TPAs.

Quantifiable outcome

• 20% improvement in patient satisfaction scores and 15% reduction in care redundancies for providers leveraging integrated data (National Academy of Medicine)
• +5 more outcomes

Named customers4 records

Segments4 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability6 records

Feature7 records

Partnerships

Six partnerships are on record, tiered core and major.

• AssureCarecoreStrategic or Co-development Partner · 1 September 2024In September 2024, AssureCare, one of the largest private companies in the healthcare IT sector headquartered in Cincinnati, OH, acquired Clinigence Health. The acquisition integrates Clinigence Health's analytics platform with AssureCare's MedCompass platform to form the Akumen brand, strengthening both companies' offerings across the healthcare continuum. The combined entity supports better-informed clinical decisions, improves patient outcomes, and drives operational efficiency across payers, providers, and pharmacies. Clinigence Health's strong presence in provider and risk-bearing entity space complements AssureCare's payer expertise.
• Nutex Health Inc.majorStrategic or Co-development Partner · 1 September 2024Prior to the AssureCare acquisition, Clinigence Holdings merged with Nutex Health in April 2022. The merger combined Clinigence's population health management technology with Nutex's hospital and physician network operations, creating Nutex Health Inc. (NASDAQ: NUTX). Clinigence Health was an affiliate partner of Nutex Health, which is a physician-led, technology-enabled healthcare services company with approximately 1500 employees nationwide and over 800 affiliated physicians.
• Amazon Web Services (AWS)coreTechnology or Integration · 12 February 2024Clinigence Health partnered with AWS to power its QMX (Quality Management X) business intelligence platform using Amazon QuickSight, a cloud-native, serverless, business intelligence tool. The collaboration enables healthcare organizations to break down immense amounts of data into actionable, data-driven solutions with generative AI reporting capabilities, scalable analytics infrastructure, and guaranteed security compliant with healthcare regulations.
• Varmed ManagementcoreStrategic or Co-development Partner · 20 July 2023In July 2023, Clinigence Health announced a partnership with Varmed Management, a Puerto Rican-based medical management company. The integration of Clinigence Health's Analytic Platform with Varmed Management's capabilities was designed to revolutionize population health management in Puerto Rico, delivering personalized patient care and enabling high-quality, accessible, and affordable healthcare through advanced analytics integration into Varmed's population health management strategy.
• Johns Hopkins ACG SystemcoreTechnology or Integration · 11 July 2023Clinigence Health leverages the Johns Hopkins ACG System for predictive modeling, risk calculations, and clinical groupings. The ACG System's predictive models are distinguished by clinical clarity and logic, excellent statistical performance validated across US and international markets, and the ability to provide whole-patient measures of multimorbidity, frailty, and medication use beyond single disease episodes.
• HCC Risk LogiccoreTechnology or Integration · 27 April 2023Clinigence Health utilizes HCC Risk Logic for risk calculations and clinical groupings alongside the Johns Hopkins ACG System. HCC Risk Logic is used to help healthcare organizations meet their risk adjustment and payment accuracy needs.

Scale indicators9 records

Recent moves6 records

Expansion highlights6 records

Direct peers

• Health Catalyst: Health Catalyst is a leading healthcare data and analytics platform serving health systems, ACOs, and payers with population health, quality, and cost-of-care analytics. It directly competes with Clinigence's value-based care analytics and quality-measurement capabilities at a much larger scale.
• Arcadia: Arcadia provides a population health management platform that aggregates EHR and claims data for ACOs, health plans, and provider groups — overlapping directly with Clinigence's clinical-plus-claims integration and MIPS/CQM reporting capabilities.
• Innovaccer: Innovaccer offers a healthcare data activation platform with population health management, value-based care analytics, and quality reporting modules used by ACOs and payers. It competes head-to-head with Clinigence in MIPS/CQM reporting and risk stratification.
• Lightbeam Health Solutions: Lightbeam Health delivers population health management and value-based care analytics to ACOs, health plans, and provider networks using aggregated clinical and claims data — closely aligned with Clinigence's core offering.
• Cedar Gate Technologies: Cedar Gate provides value-based care analytics, population health, and risk-adjustment software to payers and providers. Its risk-stratification and bundled-payment capabilities directly overlap with Clinigence's ACG- and HCC-based analytics stack.
• MedeAnalytics: MedeAnalytics delivers healthcare analytics for health plans, hospitals, and ACOs covering quality measurement, population health, and provider performance — a direct functional peer to Clinigence's value-based care analytics modules.
• Geneia: Geneia (formerly Forward Health Group) offers population health and value-based care analytics to health plans and providers. Its focus on aggregating clinical and claims data for ACO and payer reporting makes it a close functional peer to Clinigence.

Broad incumbents

• Optum (UnitedHealth Group): Optum operates one of the largest healthcare analytics franchises in the U.S., serving payers and providers with population health, risk adjustment, and quality reporting at scale. It is a broad incumbent against which smaller value-based care analytics vendors like Clinigence compete for enterprise deals.
• Premier Inc. Premier provides performance improvement, analytics, and population health solutions to health systems and ACOs. Its broader portfolio of supply chain and quality services overlaps with Clinigence's analytics-focused niche.

Emerging players

• Olive AI: Olive AI builds AI-driven automation and analytics tools for healthcare providers and payers, including workflow and revenue cycle analytics. It represents an emerging adjacent player intersecting with Clinigence's automation and analytics roadmap.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key highlights7 records

Customer concentration

• Xx.com/clinigence
• Facebookfacebook.com/Clinigence
• LinkedInlinkedin.com/company/clinigence

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles4 records

Subsidiaries2 records

Funding overview

Funding rounds1 record

Investors1 record

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A2 records

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Clinigence