Five Workflow Clouds. One AI-Enriched Data Platform.
Every cloud's output feeds the next. Practice prep builds smart agendas. Care teams close gaps and capture risk. Outreach activates patients at scale. Analytics prove what actually moved the needle — and the cycle compounds.
AI-Enriched Data Platform
Every workflow starts with the right data
Kairon ingests, normalizes, and links claims, clinical records, ADT feeds, labs, pharmacy data, and qualitative sources — meeting transcripts, field notes, CRM logs — into a single patient-to-practice model. Raw and transformed datasets are available immediately for your own analytics. The platform is payer-agnostic: BCDA, CCLF, commercial, Medicaid — same pipeline, same model.
Five Workflow Clouds.
One Flywheel.
Every cloud's output feeds the next. Practice insights build smart agendas. Agendas surface care gaps. Care teams close them. Outreach activates patients at scale. Analytics measure what moved. And the cycle compounds — what works at one practice becomes visible across your entire portfolio.
Practice Intelligence
CRM + Performance Command Center
See where to focus
For Practice Transformation Managers, Executive Directors, Medical Directors
Your field teams spend hours preparing for practice meetings — pulling metrics, reviewing notes, building agendas. Kairon does it in seconds. Auto-generated scorecards combine every metric and its underlying patient data. Smart agendas incorporate what happened last meeting so your teams stop asking the same questions every quarter.
After each meeting, Kairon records the conversation, extracts performance blockers by initiative, and aggregates them across your entire portfolio. You don't just see what's happening at one practice — you see the top 5 reasons AWVs aren't getting done across all of them.
Scorecards in seconds
Auto-generated practice profiles with metrics, trends, and patient-level drill-down
Smart agendas
AI-built meeting prep that carries forward blockers, action items, and unresolved issues
Portfolio-wide blocker analysis
See the top barriers to performance across every practice, not just one
Engagement scoring
Composite tracking of participation, sentiment, and readiness to change
Care Operations
Care Management + Risk & Quality
Coordinate care, close gaps
For Care Managers, Pharmacists, Health Coaches, Medical Coders, Quality Specialists
One unified worklist for every clinical and coding workflow. Transitions of Care triggers from ADT alerts with 48-hour and 7-day follow-up windows. Longitudinal care management runs acuity-tiered caseloads. Chronic disease management supports pharmacist-led, condition-specific protocols. Each program is configuration — not code — running on the same state machine with its own escalation rules.
For risk and quality, structured review workflows handle HCC suspect capture, recapture, and resubmissions through a multi-level QA pipeline. Care gap closure tracks Stars measures, medication adherence, and screenings with nightly sync from claims.
Unified clinical worklist
TOC, care management, and chronic disease programs in one place with built-in telehealth and AI care plans
HCC coding workflows
Suspect review, recapture, and resubmissions with multi-tier QA — offshore to onshore to confirmation
Care gap closure
Stars measures and quality gaps synced nightly from claims, routed by practice access level
Programs as configuration
Same engine runs every workflow — add new programs without writing code
Patient Activation
AI-Powered Outreach
Engage and motivate patients
For Campaign Managers, Operations Leaders
Autonomous AI voice agents call patients to schedule Annual Wellness Visits, confirm appointments, and complete outreach at scale. These aren't robocalls — each agent verifies patient identity, checks EHR availability, and books real appointments using your scheduling system. Full campaign management with holdback cohorts lets you measure actual lift.
Every campaign connects back to the flywheel. Practice permissions control who gets called. Opt-out audit trails keep you compliant. And ROI measurement ties outreach directly to billed visits — not estimated engagement, but confirmed outcomes.
AI voice agents
Configurable agent personas that verify identity, check availability, and book appointments
Campaign management
Batch outreach with retry scheduling, status tracking, and automatic escalation
Built-in A/B testing
Holdback cohorts measure real lift from treatment vs. control
Closed-loop ROI
Outreach tied to billed visits, not just calls made
Portfolio Management
ACO Builder
Shape and optimize your network
For ACO Leadership, Network Development, Business Development
Search a national provider database of 8.7 million entities to find the right practices for your network. Every TIN and NPI comes enriched with Medicare billing patterns, ACO participation history, service mix, hospital affiliations, and growth trends. Filter by volume tier, ACO status, care setting, specialty — then build scenarios.
The ACO Builder answers the question every network planner asks: "If I recruit these practices, what happens to my ACO?" Model roster projections with regional benchmarks, run shared savings scenarios at different rates, and calculate minimum savings thresholds. See the financial impact before you make the call.
National practice encyclopedia
8.7M entities with billing data, ACO history, service mix, and 19 categorical business tags
ACO scenario modeling
Add/remove TINs and see projected savings, MSR, risk scores, and track rates in real time
Growth intelligence
Volume trends, market saturation, and competitive landscape at the practice level
Attribution analysis
True panel size from CareJourney data, not just claims volume
Impact Analytics
Performance Measurement + Causal Inference
Measure what works
For ACO Leadership, Medical Directors, Operations Managers
Portfolio-level performance tracking across clinical, operational, and financial domains. Every metric is config-based — no SQL required — with entity-level assignment so each practice and contract sees its own targets and glide paths. Dashboards load in under 500 milliseconds because metrics are pre-aggregated, not queried on the fly.
This isn't a reporting silo. The metrics driving your dashboards are the same data powering worklists, outreach campaigns, and practice scorecards. One source of truth. And for the hard questions — "Did our TCM program actually reduce readmissions?" — built-in regression analysis, cohort matching, and difference-in-differences give you publishable causal evidence, not just trend lines.
Sub-500ms dashboards
Pre-aggregated metrics with drill-down from portfolio to practice to patient
Year-end predictions
AI-driven forecasting with automated alerts for off-track contracts
Config-based metrics
Add new measures without engineering — define logic, assign entities, set targets
Causal impact studies
Regression, propensity matching, and diff-in-diff to prove what actually moved the needle
Use Cases
See how ACOs, health systems, and MSOs use the five workflow clouds to close care gaps, cut costs, and prove ROI.