Innovaccer Launches AI-Powered Readmissions Management Solution to Effectively Manage Cost of Care and Improve Care Outcomes

SAN FRANCISCO--(BUSINESS WIRE)--Innovaccer Inc., a leading healthcare AI company, today announced the launch of a comprehensive, AI-powered Readmissions Management Solution designed to help health systems and providers reduce avoidable readmissions, standardize transitional care management (TCM) protocols, reduce exposure to penalties, and optimize hospital capacity across Medicare, Medicaid, and uninsured populations.

Over 200 hospitals are expected to face Hospital Readmissions Reduction Program (HRRP) penalties of more than 1% of their Medicare revenue in 2025, with the amount likely to exceed $1 million per hospital. Nationally, uncompensated care accounts to about 2% to 6% of hospital operating expenses and is expected to rise due to HR 1, and profitable procedures run the risk of being delayed or canceled due to beds being occupied by avoidable readmissions.

Higher readmission rates are often linked to hospitals with greater bed capacity, longer average lengths of stay, and larger Medicare populations. Larger volumes of cases involving chronic conditions, co-morbidities, or post-acute care needs further increase the chances for readmission. Additionally, with research suggesting that Medicaid expansion significantly contributes to reducing 30-day hospital readmissions, recent federal cuts to Medicaid spending could have an indirect impact on readmission rates in hospitals serving those populations.

Built to address the growing financial impact of readmissions among Medicare, Medicaid, or uninsured populations – especially those at risk for CMS’s HRRP penalties – Readmissions Management is designed to deliver measurable ROI through reimbursement for TCM and PCP visits, lower uncompensated care expenses, optimized use of inpatient capacity for higher-margin services, and streamlined care management documentation and billing workflows.

“Innovaccer is uniquely positioned to help health systems tackle avoidable readmissions, not just for compliance, but as a strategic lever for reducing cost and improving patient outcomes,” said Abhinav Shashank, Co-founder & CEO of Innovaccer. “Our solution brings together predictive analytics to proactively identify high-risk patients and AI-powered workflows that support timely, coordinated interventions. It’s about giving care teams the foresight and the tools to act earlier, scale smarter, and make a measurable difference where it matters most.”

Differentiation in a crowded field

While other offerings in the market try to provide sub-optimal care management workflows for the whole population, Innovaccer’s Readmissions Management solution stands out as an all-in-one approach to reducing readmissions with:

• Benchmark intelligence based on VRDC data for opportunity identification
• Create 360 degree patient and population views for all lives by unifying your healthcare data
• Advanced predictive modeling, identifying avoidable readmissions with greater accuracy across Medicare, Medicaid, and uninsured populations
• Outreach capabilities to target low-touch patients and reduce care manager’s workload in managing Medicare, Medicaid, and uninsured populations
• Mature out-of-the-box care management workflows purpose-built for TCM and high-risk patient transitions
• Agentic AI tools, including Care Management Copilot, Pre-Call Coordinator Agent, to bring efficiency and cost improvements
• Custom dashboards to track readmissions and outcomes end to end
• The solutions have proven successful across value-based care, and now you can apply it to all your populations

“Innovaccer helped us prepare for MSSP participation by ensuring our Care Navigators have easy access to the right data and protocols to make timely and reliable clinical decisions,” said Mary Kim, MD; CMO and VP Population Health Physician Enterprise at Adventist HealthCare.

General availability is now open for existing customers, with enhancements currently in development and early access phases. For prospective partners, Innovaccer offers flexible integration either as a full-stack solution or as modular augmentation to existing infrastructure.

About Innovaccer

Innovaccer activates the flow of healthcare data, empowering providers, payers, and government organizations to deliver intelligent and connected experiences that advance health outcomes. The Healthcare Intelligence Cloud equips every stakeholder in the patient journey to turn fragmented data into proactive, coordinated actions that elevate the quality of care and drive operational performance. Leading healthcare organizations like CommonSpirit Health and Banner Health trust Innovaccer to integrate a system of intelligence into their existing infrastructure—extending the human touch in healthcare. For more information, visit innovaccer.com.