ModusOne Health

What ModusOne Health does

ModusOne Health, founded in 2015 and headquartered in Atlanta, Georgia, is a privately held healthcare services firm that sells the CDxI (Clinical Diagnosis Improvement) program to large US health systems, hospitals, and outpatient clinics. The offering combines an upfront proprietary analytics assessment that identifies missed conditions, patient risk, legal exposure, and revenue leakage with physician-led evidence-based training sessions, a mobile training app (iOS, Android, web) that quizzes and tracks physician performance, monthly EMR chart reviews scoring group and individual accuracy, and printed clinical condition reference cards. Separate inpatient and outpatient variants address case mix index (CMI) improvement for hospitalists and risk adjustment factor (RAF) optimization for multi-specialty clinics respectively.

The company generates revenue through professional services engagements priced via custom, quote-based multi-year contracts tied to demonstrable ROI; customer-reported outcomes include a national health system increasing CMI from 1.19 to 1.65 and revenue by approximately $500 million, and outpatient clients realizing 15–20% RAF score gains adding millions in previously unrealized revenue. Go-to-market is a consultative enterprise field sales motion led by physician advisors and supported by a strategic partnership with Shearwater Health for clinician capacity. The customer base includes HCA Healthcare, CommonSpirit Health, Providence Health, Piedmont Healthcare, Emory University Hospital, Northside Hospital, Centra Health, North Oaks Health System, and Catholic Health. The company is bootstrapped with no disclosed external funding, operates with 11–50 employees, and is led by co-founder and CEO John Crongeyer, MD, JD, alongside co-founder Kenji Asakura, MD, and Chief Medical Officer Jaime Wise, MD.

Name

ModusOne Health

Legal name

ModusOne Health

Website

https://modusonehealth.com

Company type

Private

Founded year

2015

Operating status

Operating

Headcount range

11–50 employees

Short description

ModusOne Health sells the CDxI clinical documentation improvement program, combining proprietary analytics, physician training, and monthly chart reviews, to large US health systems and outpatient clinics to capture missed diagnoses and increase revenue.

Ownership category

akta.pro rank

Product category

Clinical Documentation Improvement Services

NAICS

Other Ambulatory Health Care Services (6219)

SIC

Services-Health Services (8000)

akta.pro primary industry

Computer-Assisted Physician Documentation (CAPD) & Clinical Documentation Improvement (CDI) (HLACAAAH)

akta.pro secondary industry

Charge Capture & Clinical Documentation Improvement (CDI) for Billing (HLACACAF)

Keywords

• Clinical documentation improvement
• Healthcare revenue optimization
• Physician education services
• Case mix index consulting
• Medical documentation accuracy

Headquarters

HQ city

Atlanta

HQ country

United States

HQ region

North America

Offices1 record

Markets served

GTM type

B2B

Offering type

Services

Cost components

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

Revenue model

1. CDI/CDxI Professional Services: Comprehensive clinical documentation improvement services including initial data analytics assessment, physician-led education sessions (in-person and online), ongoing performance management with monthly chart reviews, and tailored re-training sessions. Revenue derived from professional service engagements with healthcare organizations.

Pricing tiers

Go-to-market motion1 record

Distribution channels1 record

Marketing channels4 records

Core offering

ModusOne Health delivers the CDxI (Clinical Diagnosis Improvement) program, a physician-designed clinical documentation improvement service that combines upfront proprietary data analytics, in-person and online physician-led education, ongoing monthly chart review and performance management, and a mobile training application to help hospitals and outpatient clinics capture missed diagnoses, raise CMI and RAF scores, pass audits, and increase earned healthcare revenue.

Product overview

ModusOne Health offers the CDxI (Clinical Diagnosis Improvement) system, a comprehensive physician-designed solution for improving clinical documentation accuracy. The system comprises a core CDxI platform with distinct inpatient and outpatient variants, supported by multiple integrated modules including a mobile training app, initial assessment analytics, monthly chart review/reporting services, physician training sessions, and clinical condition reference cards. The solution combines upfront data analytics, physician-led education (both in-person and online), ongoing performance management via monthly EMR chart reviews, and a mobile app for continuous reinforcement. The platform helps healthcare organizations capture missed diagnoses, improve patient care quality, achieve compliance, and increase healthcare revenue by addressing diagnostic accuracy at the physician level.

Differentiator

Problem solved

Functional benefit

Products and services

• CDxI Inpatient Solution Inpatient-focused clinical documentation improvement solution for hospital systems and acute care facilities, designed to raise Case Mix Index (CMI), capture missed diagnoses, and increase earned hospital revenue through physician education and monthly chart review.
• CDxI Outpatient Solution Outpatient-focused clinical documentation improvement solution for multi-specialty clinics and ambulatory care settings, designed to improve Risk Adjustment Factor (RAF) scores and capture missed hierarchical condition categories (HCCs) through physician education and analytics.
• CDxI Mobile Training App Cross-platform mobile and web application that quizzes physicians on realistic clinical documentation scenarios with participation tracking and mini-quiz scoring, reinforcing diagnostic criteria learned in CDxI training sessions.

Quantifiable outcome

• CMI increased from 1.19 to 1.65 and revenue increased by $500 million at national health system
• +4 more outcomes

Named customers9 records

Segments2 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature5 records

Partnerships

One partnership is on record.

• Shearwater HealthcoreStrategic or Co-development PartnerStrategic relationship with Shearwater Health, a clinical resource company, brings additional talent and capacity to scale solutions. This partnership enables ModusOne to meet any business needs by accessing Shearwater's pool of clinical professionals. The relationship allows the company to scale its CDI/CDxI solutions to meet demand from large health system clients.

Scale indicators8 records

Recent moves1 record

Expansion highlights4 records

Broad incumbents

• 3M Health Information Systems: Long-standing incumbent in coding, CDI, and RCM software for hospitals, with deep installed base in case mix and documentation workflows — competes on the documentation accuracy dimension that ModusOne's CDxI targets.
• Health Catalyst: Healthcare data and analytics platform serving health systems for performance improvement, including acquired CDI capability; broader analytics focus but increasingly overlaps with ModusOne's documentation analytics play.
• Optum (CDI/RCM): UnitedHealth Group's health services arm offering technology-enabled CDI, risk adjustment, and RCM services to providers and payers — a broad incumbent that competes on analytics and physician engagement similar to ModusOne's CDxI.
• Nuance Communications (Microsoft): Established CDI/CQD suite serving large hospital systems, now part of Microsoft's Cloud for Healthcare; broader portfolio includes speech recognition and ambient clinical documentation, providing deeper EHR integration than ModusOne.

Direct peers

• ChartWise (acquired by Health Catalyst): CDI software offering query prioritization, analytics, and physician engagement tools for inpatient CDI programs; comparable ModusOne inpatient CDxI on documentation accuracy use case.
• AQuity Solutions: Provides medical coding, CDI, and clinical documentation services to hospitals and physician groups, with both technology and services components — comparable services-heavy model to ModusOne's CDxI delivery.
• Dolbey Systems: Specialist CDI/Computer-Assisted Coding vendor offering Fusion CDI and front-end speech recognition to mid-sized and enterprise health systems, directly comparable to ModusOne's clinical documentation focus.
• Iodine Software: Direct competitor focused on AI-driven clinical documentation improvement and CDI software for inpatient settings, offering query generation and chart review tools to large health systems — overlapping head-to-head with ModusOne's CDxI inpatient offering.
• Streamline Health: Provides CDI, coding, and RCM software to health systems including eValuator pre-bill analytics — directly competing in the documentation improvement and revenue integrity market.

Emerging players

• CodaMetrix: AI-driven autonomous medical coding platform for hospitals and health systems, addressing documentation-to-billing accuracy; an emerging competitor in the documentation improvement category adjacent to ModusOne.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/modusone_health
• Facebookfacebook.com/ModusOneHealth
• LinkedInlinkedin.com/company/modusone-health

Revenue estimate

Valuation estimate

Number of profiles

Profiles11 records

Funding overview

Funding rounds

Investors

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

M&A

Investments

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

Frequently asked questions about ModusOne Health