Focus Care
Focus Care is a US healthcare services company that delivers in-home and virtual health risk assessments, member engagement, and risk adjustment coding to Medicare Advantage plans, ACOs, physician offices, and PACE networks, and has extended into AI clinical documentation via its CareScripts platform.
- Company typePrivate
- Founded2002
- HeadquartersWoburn, United States
- Headcount251–500
- GTM typeB2B
- OfferingServices
What Focus Care does
Focus Care is a privately-held US healthcare services company headquartered in Woburn, Massachusetts, that delivers in-home and virtual health risk assessments, member engagement programs, risk adjustment coding, and care coordination services primarily to Medicare Advantage health plans, accountable care organizations (ACOs), physician offices, and PACE networks. The company operates an 11,000+ national provider network executing 40,000+ annual member interactions, supported by a 24/7 US-based HIPAA-compliant call center and a proprietary NCQA-certified patient assessment platform that captures the 37 CMS-required elements for wellness and health promotion appraisals. Its core technology stack combines the certified assessment tool, HCC coding and risk adjustment analytics (98% audit-validated accuracy), and a multi-channel member engagement platform with EHR integration capabilities.
In 2025 Focus Care extended into AI-powered clinical documentation through CareScripts, a proprietary platform that uses ambient voice recognition and generative AI to convert real-time provider-patient conversations into structured SOAP-format medical notes in under 30 seconds at 90%+ accuracy. The platform is SOC 2 Type II and HIPAA compliant, supports specialty-adaptive templates, and is positioned as a subscription offering to hospitals, clinics, and health systems beyond the company's traditional payer-side customer base. Revenue is generated through multi-year enterprise contracts with health plans and ACOs, per-evaluation fees paid to participating providers, subscription fees for CareScripts, and targeted Colorado Medicaid case management and life skills training services delivered through a Denver regional office. The company was founded circa 2002 as a medical transcription and nurse staffing firm in the Boston area, pivoted around 2015 toward Medicare Advantage risk adjustment, and holds ISO 27001:2013, SOC 2 Type II, NCQA, and HIPAA certifications alongside Boston Globe Top Places to Work (2025) and Top Workplaces (2024) recognition.
Focus Care firmographics
Firmographics- Name
- Focus Care
- Legal name
- Focus Cares LLC
- Website
- https://focuscares.com
- Company type
- Private
- Founded year
- 2002
- Operating status
- Operating
- Headcount range
- 251–500 employees
- Short description
- Focus Care is a US healthcare services company that delivers in-home and virtual health risk assessments, member engagement, and risk adjustment coding to Medicare Advantage plans, ACOs, physician offices, and PACE networks, and has extended into AI clinical documentation via its CareScripts platform.
- Ownership category
- akta.pro rank
Focus Care industry classification
Industry- Product category
- Healthcare Member Engagement and Risk Adjustment Services
- NAICS
- Services for the Elderly and Persons with Disabilities (624120), Social Assistance (624)
- SIC
- Services-Health Services (8000), Services-Home Health Care Services (8082), Services-Misc Health & Allied Services, Nec (8090)
- akta.pro primary industry
- Hospice & Palliative Care Care Coordination / Navigation (HLADAHAK)
- akta.pro secondary industries
- Virtual Second Opinion & Care Navigation Platforms (HLALAAAF), Care Management & Coordination Platforms (case/disease management workflows) (HLACAHAD), Care Coordination & Navigation (Multi-Provider) (HLADALAB)
Keywords
Where Focus Care is headquartered
LocationHeadquarters
- HQ city
- Woburn
- HQ country
- United States
- HQ region
- North America
Offices2 records
Markets served
Focus Care business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure
Revenue model
- In-Home Health Assessment Services: Focus Care conducts comprehensive health assessments for health plan members in their homes, virtual, or telephonic settings. Revenue generated through contracted arrangements with health plans, ACOs, and physician offices for member outreach, scheduling, provider support, and quality measure capture services.
- Risk Adjustment Coding & Quality Services: HCC coding services for in-home and virtual health assessments, providing accurate documentation and compliance support for health plans. Services include prospective coding, care gap closure, and quality measure optimization.
- CareScripts AI Documentation Platform: AI-powered clinical documentation platform for healthcare providers. Generates revenue through platform licensing and subscription fees for ambient voice AI documentation services.
- Provider Network Management: Nurse practitioners and providers receive competitive per-evaluation rates for conducting in-home health risk assessments. Providers receive supplies, travel incentives, volume bonuses, and liability coverage.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Other | Multi-year contract | Enterprise Health Plan Contracts |
| Subscription | Monthly | CareScripts AI Documentation Platform |
| Unit Pricing | Pay-as-you-go | Provider Per-Evaluation Compensation |
| Other | Pay-as-you-go | Annual Wellness Visit Reimbursement |
Go-to-market motion2 records
Distribution channels5 records
Marketing channels6 records
Focus Care product offering
Product offeringCore offering
Focus Care is a national healthcare services company that conducts, supports, and manages end-to-end in-home, virtual, and telephonic Comprehensive Health Assessments, Quality Screenings, and Annual Wellness Visit programs for health plans, ACOs, physician offices, and PACE networks. The company pairs a 11,000+ provider network with proprietary NCQA-certified assessment technology and the CareScripts AI-powered clinical documentation platform, delivering risk adjustment coding, member engagement, welcome calls, and care coordination services across the U.S.
Product overview
Focus Care is a national healthcare services company offering a comprehensive suite of member engagement, health risk assessment, care management, and clinical consultancy solutions. The portfolio centers on CareScripts (AI-powered clinical documentation), In-Home Health Assessment Solutions (risk adjustment programs with 11,000+ provider network), Member Engagement Solutions (telephonic outreach, welcome calls, PACE engagement), Colorado Medicaid Transitions (targeted case management, life skills training), Telehealth Solutions (virtual assessments with 24/7 call center), and Annual Wellness Visit Services (physician office solutions with NCQA-certified assessment tools). These solutions work together to help health plans improve outcomes, close care gaps, and maximize reimbursement through outreach, assessments, coding, and care coordination.
Differentiator
Problem solved
Functional benefit
Brands
- CareScripts: AI-powered clinical documentation platform that uses ambient voice recognition and generative AI to automatically create structured clinical notes from real-time provider-patient conversations.
- Colorado Medicaid Transitions
Products and services
- CareScripts AI-driven clinical documentation platform that uses ambient voice recognition and generative AI to automatically convert real-time patient conversations into structured medical notes in under 30 seconds with 90%+ accuracy, with SOC 2 Type II and HIPAA-compliant security, designed for hospitals, clinics, and health systems.
- In-Home Health Assessment Solutions Comprehensive in-home, telephonic, and virtual health risk assessment services for Medicare, Medicaid, and ACA plan members, supported by a national network of 11,000+ licensed clinicians and Focus Care's NCQA-certified patient assessment tool.
- HRA Member Engagement Health Risk Assessment engagement solutions including member outreach, scheduling, care coordination, and use of Focus Care's NCQA-certified patient assessment tool, achieving an 85% scheduling success rate through an emotional intelligence approach.
- PACE Engagement Engagement services tailored for Programs for All-Inclusive Care for the Elderly (PACE) networks, including appointment scheduling, transportation arrangement, care coordination, multi-lingual participant support, and analytics.
- Colorado Medicaid Transitions Medicaid transition services for Colorado members including Targeted Case Management, Life Skills Training, and Peer Mentorship to assist individuals transitioning from long-term care facilities to home and community-based settings under HCBS waivers.
- Telehealth Solutions Virtual clinical assessment solutions with 24/7 HIPAA-compliant call center, remote member monitoring, chronic disease management, and telehealth platform supported by Focus Care's 11,000 nationwide provider network.
- Annual Wellness Visit (AWV) Services End-to-end Annual Wellness Visit (AWV) solutions for physician offices including member outreach, appointment scheduling, virtual AWV management, and access to Focus Care's NCQA-certified patient assessment tool.
- Risk Adjustment Services End-to-end Medicare, Medicaid, and Dual Assessment programs covering outreach, scheduling, provider support, HCC coding, and quality measure capture, with 98% HCC coding accuracy during bi-monthly external audits.
- Quality Gap Closure Solutions Targeted member outreach and screenings including bone density, diabetic retinal exam, FIT, microalbumin, A1c, LDL, spirometry, and PAD testing to close HEDIS and CMS Star Ratings care gaps.
- Standalone AWV Patient Assessment Tool SaaS tablet-based patient assessment tool allowing patients to complete Annual Wellness Visit questions while waiting for appointments, capturing CMS-required health risk assessment data and integrating with office EMR systems.
- NCQA Comprehensive Patient Assessment Tool NCQA-certified patient assessment tool evaluating 37 CMS-required elements covering chronic disease, injury risk, modifiable risk factors, and urgent health needs, tailored to the age 65+ Medicare population.
- Healthcare Call Center Operations 24/7 U.S.-based HIPAA-compliant healthcare call center services with multi-channel support (phone, email, chat, web portals), HRA scheduling, care coordination, and emotional intelligence-trained member engagement.
- Welcome Call Solutions Personalized Medicare welcome call programs reaching new enrollees within 30 days to gather information, explain plan features, and connect members with relevant health plan resources.
- Targeted Case Management Case management services assisting Health First Colorado (Medicaid) members transitioning from long-term care facilities back to home and community-based settings under HCBS waivers.
- Life Skills Training Colorado Medicaid Waiver Program service helping individuals learn independent living skills including cooking, budgeting, transportation navigation, and community integration.
- Retrospective Chart Coding Retrospective chart coding services combining advanced analytics with expert coding to identify gaps in care, uncover missed diagnoses, and optimize risk adjustment programs for health plans.
Quantifiable outcome
- 85% IHA Scheduling Conversion Rate
- +8 more outcomes
Companies that use Focus Care
Customer profileNamed customers5 records
Segments6 records
Ideal customer profiles6 records
Focus Care technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration2 records
AI capability6 records
Feature5 records
Focus Care partnerships and signals
Strategic signalScale indicators12 records
Recent moves5 records
Expansion highlights6 records
Focus Care competitors and assessment
Company assessmentDirect peers
- Inovalon: Inovalon is a direct peer in risk adjustment analytics, HCC coding, and population health management for health plans. Comparable in supporting MA plan reimbursement workflows and quality measure capture, though with a more software/data-centric model rather than field clinician deployment.
- Healthmine: Healthmine is a direct peer in Medicare Advantage member engagement, quality measure improvement (Star Ratings), and member wellness programs. Comparable in serving MA plans seeking risk and quality performance uplift, though with a more tech/digital engagement orientation.
- Wellbox: Wellbox is a direct peer providing chronic care management, annual wellness visits, and care coordination services for Medicare beneficiaries on behalf of physician practices and health plans. Closely comparable in AWV delivery model and physician-office customer segment.
- Signify Health: Signify Health is a direct peer in in-home health risk assessments, risk adjustment coding, and value-based care enablement for Medicare Advantage plans. Highly comparable in customer base (MA plans) and core service model (in-home and virtual assessments plus analytics), and was acquired by CVS Health in 2023, illustrating the strategic value of this category.
- Matrix Medical Network: Matrix Medical Network is a direct peer providing in-home health risk assessments, care management, and member engagement services to Medicare Advantage and Medicaid plans. Closely comparable in delivery model (in-home clinician network, health plan contracts, NCQA-aligned tools) and target customers.
Emerging players
- Suki AI: Suki AI is an emerging player in ambient clinical documentation and AI assistants for clinicians, directly comparable to CareScripts in functionality (voice-to-note, EHR integration). It has secured notable health system customers and competes for the same hospital and clinic buyer.
- Abridge: Abridge is an emerging ambient AI clinical documentation competitor to Focus Care's CareScripts platform. Targets the same hospital, clinic, and health system buyers with generative AI scribe technology and has raised substantial venture funding, representing a credible threat in the AI documentation category.
Broad incumbents
- Cotiviti: Cotiviti is a broad incumbent in payment accuracy, risk adjustment, and quality analytics for health plans. It overlaps with Focus Care's risk adjustment and quality gap closure offerings but operates at greater scale across payer and provider markets as part of a broader healthcare analytics portfolio.
- Optum (UnitedHealth Group): Optum is a broad incumbent offering risk adjustment, in-home assessments, care management, and clinical analytics as part of its integrated health services platform. Overlaps with nearly every Focus Care service line and benefits from unmatched scale and EHR/RCM data assets, making it a key competitive benchmark.
Regional players
- Advanta Healthcare Solutions: Advanta Healthcare Solutions is a regional player offering in-home health assessments and risk adjustment services with concentration in select US states. Comparable in delivery model and customer type (MA plans) but with a more limited geographic footprint than Focus Care's national provider network.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat7 records
Key risks6 records
Key highlights7 records
Customer concentration
Focus Care social profiles
Digital presenceFocus Care compliance and trust
Trust signalCompliance4 records
Focus Care financial estimates
Financial estimateRevenue estimate
Valuation estimate
Focus Care leadership team
Management profileNumber of profiles
Profiles2 records
Focus Care funding detail
Funding detailFunding overview
Funding rounds
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Focus Care M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Focus Care
What does Focus Care do?
Focus Care is a national healthcare services company that conducts, supports, and manages end-to-end in-home, virtual, and telephonic Comprehensive Health Assessments, Quality Screenings, and Annual Wellness Visit programs for health plans, ACOs, physician offices, and PACE networks. The company pairs a 11,000+ provider network with proprietary NCQA-certified assessment technology and the CareScripts AI-powered clinical documentation platform, delivering risk adjustment coding, member engagement, welcome calls, and care coordination services across the U.S.
Is Focus Care a public or private company?
Focus Care is a private company. It is classified as founder individual operated bootstrapped and is currently operating.
When was Focus Care founded?
Focus Care was founded in 2002. It employs 251 to 500 people.
Where is Focus Care based?
Focus Care is headquartered in Woburn, United States, in the North America region.
How does Focus Care make money?
Four revenue lines are on record. In-Home Health Assessment Services are the primary driver. The others are risk Adjustment Coding & Quality Services, careScripts AI Documentation Platform and provider Network Management.
Who are Focus Care's main competitors?
Direct peers on record are Inovalon, Healthmine, Wellbox, Signify Health and Matrix Medical Network. Emerging players are Suki AI and Abridge. Broad incumbents are Cotiviti and Optum (UnitedHealth Group). Advanta Healthcare Solutions is listed as a regional player.
Does Focus Care have an API?
No public API is recorded for Focus Care.
What industry is Focus Care in?
Focus Care's product category is Healthcare Member Engagement and Risk Adjustment Services. Its primary akta.pro industry code is HLADAHAK, Hospice & Palliative Care Care Coordination / Navigation, with a secondary code of HLALAAAF, Virtual Second Opinion & Care Navigation Platforms. Its NAICS code is 624120 and its SIC code is 8000.