IntusCare Expands IRIS Into End-to-End Risk Adjustment Platform for PACE Organizations

NEW YORK—IntusCare, a software provider for the Programs of All-inclusive Care for the Elderly (PACE) market, has announced a major expansion of its IRIS risk adjustment platform.

Originally launched in 2024 to support coding validation and pre-encounter preparation, the solution gives PACE organizations visibility across the full risk adjustment lifecycle. According to the company, it connects clinical documentation, Centers for Medicare & Medicaid Services (CMS) submission tracking, reconciliation and financial analytics to help teams understand how risk adjustment activity affects risk adjustment factor (RAF) and revenue performance.

Accurate risk adjustment depends on more than documenting diagnoses. PACE organizations must also know whether their CMS submissions have moved through the pipeline, how documented conditions are affecting RAF scores, and what this means for reimbursement. Yet traditionally, clinical, eligibility and financial data live in separate systems, leaving teams to piece together periodic reports to understand how documentation and submission activities impact financial results downstream. 

IRIS brings all these data points together and updates them daily. Using IRIS, PACE teams can monitor their CMS pipeline, investigate stalled or rejected submissions and access financial analytics to understand the potential impact on RAF scores and revenue.

“PACE has no shortage of reports showing what happened after the fact. What has been missing is the ability to understand what is happening now and whether there’s still time to influence clinical and financial outcomes,” said Nima Karamooz, vice president of product management at IntusCare. “We expanded IRIS to help organizations move from retrospective analysis to proactive intervention.”

Over the past two years, IRIS has supported over 30 PACE organizations across the nation, IntusCare said.