Vatica Health
Vatica Health is a U.S. healthcare technology company that delivers a PCP-centric, EMR-integrated risk adjustment and clinical quality platform for health plans and providers. Pairs proprietary cloud software with licensed clinical consultants and coders, sponsored by health plans at no cost to PCPs.
- Company typePrivate
- Founded2011
- HeadquartersNashville, United States
- Headcount251–500
- GTM typeB2B
- OfferingSoftware
What Vatica Health does
Vatica Health is a U.S. healthcare technology company that builds a PCP-centric risk adjustment and clinical quality platform, pairing licensed clinical consultants and AAPC-certified coders with proprietary cloud-native software that integrates directly into provider EMR systems (Epic, athenahealth, eClinicalWorks via Vatica Connect). The enterprise data platform (EDP) synthesizes EMR and health-plan data to create condition lists, surface care gaps, and capture HCC diagnoses with 100% clinical-coding validation prior to submission; the Well365 member-engagement layer is HITRUST-certified. Founded in 2011, the company is headquartered in St. Louis Park, Minnesota, and scaled to roughly 700 employees serving 14 national and regional health plan clients, 10,000-plus provider partners, 1.9 million-plus patients, and 13,000-plus contracted providers across 40 states.
The business model is health-plan-sponsored: payers fund Vatica for their contracted provider networks and pay program revenue per completed risk-adjustment visit, so PCPs and provider organizations receive the solution and clinical support at zero direct cost. Providers benefit from EMR-embedded workflows, an 80% PCP completion rate, and 12-16% improvements in coding accuracy and specificity, while health plans gain double patient penetration, better Stars/HEDIS performance, and reduced RADV compliance risk. Distribution is sales-led and direct, with separate enterprise sales directors targeting payers and provider organizations, supplemented by CME-accredited education, customer advocacy (case studies), and KLAS-driven credibility. The company has earned the Best in KLAS designation in Risk Adjustment Software and Professional Services for three consecutive years (2023-2025), reaching a 94.4/100 category-leading score and a +56 NPS from health-plan clients.
In 2023, Vatica was acquired by Frazier Healthcare Partners to fund continued growth and platform expansion. In October 2025, Vatica completed a $480 million merger with Cozeva, a #1 Best in KLAS quality and population-health platform, creating a combined entity serving 30 health plans and 120,000 providers and operated by a combined leadership team led by CEO Keith Anderson (former Optum at Home GM and Home & Community CSO). The merged entity retains dual category leadership across risk adjustment and quality, is SOC 2 Type 2 and HITRUST certified, and is positioning around CMS-HCC V28, RADV audits, and the 2027 Final Notice as the regulatory tailwind for prospective, provider-centric risk adjustment.
Vatica Health firmographics
Firmographics- Name
- Vatica Health
- Legal name
- Vatica Health, Inc.
- Website
- https://vaticahealth.com
- Company type
- Private
- Founded year
- 2011
- Operating status
- Operating
- Headcount range
- 251–500 employees
- Short description
- Vatica Health is a U.S. healthcare technology company that delivers a PCP-centric, EMR-integrated risk adjustment and clinical quality platform for health plans and providers. Pairs proprietary cloud software with licensed clinical consultants and coders, sponsored by health plans at no cost to PCPs.
- Ownership category
- akta.pro rank
Vatica Health industry classification
Industry- Product category
- Healthcare Risk Adjustment and Quality Software
- NAICS
- Computer Systems Design Services (541512), Custom Computer Programming Services (541511), Computer Systems Design and Related Services (54151), Other Computer Related Services (541519)
- SIC
- Services-Health Services (8000), Services-Prepackaged Software (7372), Services-Computer Programming, Data Processing, Etc. (7370)
- akta.pro primary industry
- EHR Implementation, Optimization, Training & Managed Services (HLACAAAL)
- akta.pro secondary industry
- Patient Engagement, Education & Messaging Platforms (portal/CRM integrated) (HLALABAJ)
Keywords
Where Vatica Health is headquartered
LocationHeadquarters
- HQ city
- Nashville
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Vatica Health business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Personnel, Technology or R&D, Marketing or Sales, Operations, Infrastructure
Revenue model
- Health Plan Sponsorship / Subscription: Vatica's primary revenue model involves health plans sponsoring the Vatica solution for their contracted provider networks. Sponsoring health plans cover the cost of the solution and provide health plan program revenue for each completed visit. Provider organizations receive this funding at no cost — there is no added financial burden to PCPs. Health plans benefit from improved coding accuracy, double patient penetration, and 12-16% increase in accuracy and specificity.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Multi-year contract | Health plan-sponsored solution — no cost to providers |
Go-to-market motion1 record
Distribution channels3 records
Marketing channels6 records
Vatica Health product offering
Product offeringCore offering
Vatica Health provides a PCP-centric risk adjustment and quality of care platform that pairs expert clinical teams (licensed nurses, advanced practice providers, AAPC-certified clinical validation auditors) with proprietary cloud-native technology and EMR-native integration. The solution synthesizes EMR and health plan data to capture more accurate and complete diagnosis codes at the point of care, and is sponsored by health plans for use by their contracted provider networks. Post-merger with Cozeva, the offering extends into a unified SaaS platform for quality performance, population health management, and payer-provider collaboration.
Product overview
Vatica Health offers a unified, integrated platform for value-based care enablement centered on risk adjustment and clinical quality solutions. The portfolio combines Vatica Health's core risk adjustment solution (which pairs expert clinical teams with technology at the point of care) with Vatica Connect (EMR-integrated workflow tool), Well365 (HITRUST-certified member engagement platform), and the Cozeva Platform (acquired through merger with Cozeva in 2025, adding NCQA-certified quality and population health management capabilities). Together, these products form a comprehensive suite that serves both health plans and providers, integrating clinical data synthesis, coding and documentation workflows, quality performance tracking, and payer-provider collaboration into a single ecosystem.
Differentiator
Problem solved
Functional benefit
Brands
- Vatica Connect: EMR-integrated risk adjustment workflow solution that allows providers to complete coding directly within their existing Electronic Medical Record system (Epic, athenahealth, eClinicalWorks).
- Well365
Products and services
- Vatica Health Risk Adjustment and Quality of Care Solution Provider-centric risk adjustment and clinical quality solution that pairs expert clinical teams (RNs, advanced practice providers, and AAPC-certified clinical validation auditors) with comprehensive data and intuitive technology at the point of care to help health plans and providers capture accurate and complete diagnosis codes, close care gaps, and reduce compliance risk.
- Vatica Connect EMR-integrated application that enables PCPs to complete risk adjustment workflows directly within their existing Electronic Medical Record system (Epic, athenahealth, eClinicalWorks) without additional logins. Delivers concise alerts, condition lists contextualized by clinical evidence, intuitive coding/documentation workflows, and automatic transmission of accepted diagnosis codes back to the EMR.
- Well365 HITRUST-certified healthcare platform from Vatica Health that supports member engagement, Annual Wellness Visits (AWV), Enhanced Annual Wellness Visits (EAWV), and clinical workflows for risk adjustment and quality programs.
- Cozeva Platform SaaS platform for value-based care enablement focused on quality of care, population health management, and payer-provider collaboration, integrating real-time data exchange, quality performance, and risk adjustment into everyday clinical workflows. NCQA-certified and HITRUST-certified. Earned the 2025 Best in KLAS distinction for Risk Adjustment (Quality Platform) and 2026 Best in KLAS for Risk Adjustment: Point-Of-Care and In-Home Health Assessments (91.2/100).
Quantifiable outcome
- 12-16% improvement in coding accuracy and specificity
- +9 more outcomes
Companies that use Vatica Health
Customer profileNamed customers10 records
Segments3 records
Ideal customer profiles3 records
Vatica Health technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration3 records
AI capability4 records
Feature5 records
Vatica Health partnerships and signals
Strategic signalPartnerships
Three partnerships are on record, tiered core and minor.
- CozevacoreVatica Health completed its merger with Cozeva on October 31, 2025 (announced October 31; completed November 3, 2025). Cozeva is a premier SaaS platform for value-based care enablement focused on quality of care, population health management, and payer-provider collaboration. The merger was for $480 million. The combined entity brings together Vatica's #1-rated Best in KLAS risk adjustment platform and Cozeva's #1-rated Best in KLAS quality platform. Keith Anderson serves as CEO of the combined entity, with Khanh Nguyen (Cozeva CEO) continuing in leadership. Post-merger, the combined entity is trusted by 30 health plans and 120,000 providers.
- Nordic Capital (Arcadia partnership)minorArcadia (a competitor/comparable VBC technology company) announced a strategic partnership with Nordic Capital in July 2025, reflecting significant capital flow into VBC-enabling technology platforms. Referenced in a TripleTree industry analysis.
- Great Lakes Integrated Network IPA (GLIN IPA)coreVatica collaborated with GLIN IPA and Dr. Paul Shields (CMO and CEO of GLIN IPA) on a joint webinar for members of Health Plan Alliance. Dr. Shields highlighted how a plan-agnostic, PCP-centric coding solution best meets stringent compliance regulations and improves patient care. GLIN IPA has more than 900 providers and uses Vatica's clinicians to review data, increasing accuracy and saving PCPs time.
Scale indicators15 records
Recent moves6 records
Expansion highlights7 records
Vatica Health competitors and assessment
Company assessmentDirect peers
- Cotiviti: Major risk adjustment and payment accuracy vendor serving health plans with coding, analytics, and clinical services. Highly comparable to Vatica given overlapping payer customer base and risk adjustment focus; Vatica's CTO previously led teams at Cotiviti.
- Advantmed: Risk adjustment and quality solutions provider serving health plans and provider organizations. Recently recapitalized by Webster Equity Partners (2025), positioning it as a direct competitor in prospective and retrospective risk adjustment services.
- Arcadia: Value-based care enablement platform combining EHR data aggregation, risk adjustment, and population health analytics for payers and providers. Strategic partnership with Nordic Capital (2025) signals major capital deployment in the same space.
- Reveleer: AI-enabled risk adjustment, quality improvement, and clinical data platform serving health plans. Directly comparable given shared focus on prospective and retrospective risk adjustment workflows for payer customers.
- Apixio (Centene): AI-powered risk adjustment and quality measurement platform, now part of Centene. Comparable given its payer-sponsored risk adjustment focus and overlap with Vatica's health plan customer segments.
Broad incumbents
- Optum (UnitedHealth Group): Largest healthcare technology and services platform, offering risk adjustment, population health, and provider enablement at massive scale. Vatica's CEO came from Optum, and Optum serves as both a potential competitor and a benchmark for scale in the same space.
- Inovalon: Cloud-based healthcare data analytics platform serving payers, providers, and pharma with risk score accuracy, quality, and population health solutions. A broad incumbent offering overlapping capabilities across Vatica's risk adjustment and quality stack.
- NextGen Healthcare: Ambulatory EHR and population health vendor serving PCPs and specialty practices with integrated quality and risk adjustment tooling. Adjacent competitor with overlapping provider customer base and risk adjustment workflow capabilities.
Emerging players
- Health Catalyst: Data and analytics platform for healthcare providers and payers focused on outcomes improvement, risk, and quality. Comparable to Vatica's Cozeva side in payer-provider collaboration and quality measurement.
- Innovaccer: Healthcare data platform unifying EMR, claims, and social data for value-based care, risk stratification, and quality programs. Comparable to Vatica's payer-agnostic aggregation and population health capabilities post-Cozeva merger.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat6 records
Key risks6 records
Key highlights7 records
Customer concentration
Vatica Health social profiles
Digital presenceVatica Health compliance and trust
Trust signalCompliance2 records
Vatica Health financial estimates
Financial estimateRevenue estimate
Valuation estimate
Vatica Health leadership team
Management profileNumber of profiles
Profiles14 records
Vatica Health subsidiaries and ownership
Company hierarchySubsidiaries1 record
Vatica Health funding detail
Funding detailFunding overview
Funding rounds1 record
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Vatica Health M&A and investment
M&A and investmentM&A2 records
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Vatica Health
What does Vatica Health do?
Vatica Health provides a PCP-centric risk adjustment and quality of care platform that pairs expert clinical teams (licensed nurses, advanced practice providers, AAPC-certified clinical validation auditors) with proprietary cloud-native technology and EMR-native integration. The solution synthesizes EMR and health plan data to capture more accurate and complete diagnosis codes at the point of care, and is sponsored by health plans for use by their contracted provider networks. Post-merger with Cozeva, the offering extends into a unified SaaS platform for quality performance, population health management, and payer-provider collaboration.
Is Vatica Health a public or private company?
Vatica Health is a private company. It is classified as private equity controlled and is currently operating.
When was Vatica Health founded?
Vatica Health was founded in 2011. It employs 251 to 500 people.
Where is Vatica Health based?
Vatica Health is headquartered in Nashville, United States, in the North America region.
How does Vatica Health make money?
One revenue line is on record: health Plan Sponsorship / Subscription.
Who are Vatica Health's main competitors?
Direct peers on record are Cotiviti, Advantmed, Arcadia, Reveleer and Apixio (Centene). Broad incumbents are Optum (UnitedHealth Group), Inovalon and NextGen Healthcare. Emerging players are Health Catalyst and Innovaccer.
Does Vatica Health have an API?
No public API is recorded for Vatica Health.
What industry is Vatica Health in?
Vatica Health's product category is Healthcare Risk Adjustment and Quality Software. Its primary akta.pro industry code is HLACAAAL, EHR Implementation, Optimization, Training & Managed Services, with a secondary code of HLALABAJ, Patient Engagement, Education & Messaging Platforms (portal/CRM integrated). Its NAICS code is 541512 and its SIC code is 8000.