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.

Claims & EOBsEHR & CCDAADT FeedsLabs & RxAttribution & RostersRisk & HCC DataQuality GapsCMS ReportsCost & BenchmarksProvider DirectoriesMeeting TranscriptsField NotesEngagement LogsFHIR APIsClaims & EOBsEHR & CCDAADT FeedsLabs & RxAttribution & RostersRisk & HCC DataQuality GapsCMS ReportsCost & BenchmarksProvider DirectoriesMeeting TranscriptsField NotesEngagement LogsFHIR APIs

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.

UNIFIEDDATAPLATFORMPracticeIntelligenceSee where to focusCareOperationsCoordinate care,close gapsPatientActivationEngage and motivate patientsPortfolioManagementShape your networkImpactAnalyticsMeasurewhat works
01

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.

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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

02

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.

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NCQA Prevalidated for Population Health Management. Clients using Kairon's Care Operations Module receive automatic credit on Data Integration and Case Management Systems during NCQA accreditation surveys.

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

03

Patient Activation

AI Voice Outreach + Staff Calling

Put an AI voice agent on the list

For Outreach Leaders, Operations Leaders, Outreach Coordinators

An AI voice agent calls patients from any Kairon worklist as a campaign, following a script your team writes, with a cap on attempts per patient. Each connected call is transcribed, and a structured summary records the outcome and any callback the patient asks for. A random share of the list can be held back from calls, so campaign reporting compares appointment rates for called patients with patients who weren’t called.

Underneath, care managers and outreach coordinators call patients from the worklist in their browser, each from a local number assigned to them. Patients can call that number back, missed calls go to a voicemail inbox, and staff mark each attempt reached, voicemail, no answer, wrong number or refused. Video visits start from the same screen, and the patient joins from a link.

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AI voice agent

Available now. Calls a worklist as a campaign and transcribes each connected call

Randomized holdback

A random share of each campaign held back from calls, for comparison

Calling from the worklist

Browser calling from a local number, with callbacks, voicemail and recording

Attempt outcomes

Each attempt marked with its outcome, the next one set in one click, do-not-contact numbers blocked

04

Portfolio Management

Network Performance + Growth

Know what moves your numbers

For ACO Leadership, Finance and Analytics, Network Development

An ACO earns shared savings when spending comes in under its benchmark, so Portfolio Management starts with cost. The Leverage Index compares each practice’s cost trend with the national trend, after crediting its change in risk, and scales it by attributed patients. Cost attribution splits a change in cost per person-year into leavers, joiners and the patients who stayed, by practice, facility or provider.

Attribution health shows who stayed, who is new or returning and why patients left. For growth, Kairon ranks the practices in your territory by Medicare panel size, writes a conversation guide on each target and matches your Salesforce accounts and leads to the same practices.

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Leverage Index

Each practice’s cost trend against the national trend, after crediting its change in risk

Cost attribution

Cost change split into leavers, joiners and stayers, down to the patient

Attribution health

Who stayed, who is new or returning, and why patients left

Network growth

Targets, conversation guides, Salesforce matching and pipeline reports

05

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.

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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.

See use cases