Population Health
Intelligence Platform
RAFIQ Health is a population health intelligence platform designed for health plans, provider organizations, self-funded employers, and international healthcare markets — serving physician groups, IPAs, ACOs, Medicare Advantage organizations, commercial health plans, self-funded employers, municipalities, and international healthcare organizations.
Seven engines. One platform.
Every capability your organization needs to manage risk, control cost, and improve outcomes at scale.
Executive Command Center
Real-time KPIs for high-cost claimants, frequent ER users, admission risk, and HCC recapture opportunities.
High-Cost Claimant Analytics
Surface the top 1% of cost drivers with deep clinical profiles, utilization patterns, and intervention tracking.
Admission Risk Engine
Machine learning models predict avoidable admissions up to 30 days in advance with 92% accuracy.
Pharmacy Optimization
Biosimilar switching, site-of-care steerage, adherence monitoring, and specialty drug management.
HCC Navigator
Track RAF scores, risk trends, and HCC history across populations with automated recapture workflows.
Care Gap Management
Close quality measure gaps, track AWV compliance, and improve Star Ratings with automated outreach.
Data Upload Center
Self-service ingestion for eligibility, claims, pharmacy, and provider data with built-in validation.
Built for decision-makers
From the C-suite to the care manager's desk, every screen is designed for clarity, speed, and action.
Executive Dashboard
Real-time population health KPIs, spend trends, and high-risk member surfacing.
Health Plan Command Center
Enterprise MLR, PMPM, disease registries, and board-ready opportunity scoring.
High-Risk Worklist
Prioritized intervention lists with severity scoring and rapid-action workflows.
Member 360 Profile
Complete clinical, utilization, pharmacy, and intervention history in one view.
Intelligence that drives action
Most platforms show you what happened. RAFIQ tells you what to do next — and quantifies the impact of every intervention before you deploy it.
Predictive, Not Reactive
Our models flag members 30 days before they become high-cost — not after the admission.
Financial-Grade Accuracy
Every insight is paired with estimated savings, RAF impact, and quality score improvement.
Built for Value-Based Care
Designed around ACO, MA, and commercial risk contracts — not fee-for-service reporting.
90-Day Implementation
Go from contract to live insights in a single quarter with our guided data onboarding.
From data to decision in 30 days
A proven implementation playbook that gets you from contract signature to live insights faster than any competitor.
Data Ingestion
Upload eligibility, medical claims, pharmacy claims, and provider roster via our self-service Data Upload Center.
Validation & Enrichment
Automated data quality checks, NPI matching, diagnosis mapping, and HCC code enrichment.
Model Activation
Risk stratification, admission prediction, and cost opportunity models train on your population within 48 hours.
Action & Measure
Care managers intervene via Member 360. Executives track ROI in real time. Quality scores improve quarter over quarter.
Measurable impact. Real returns.
Our clients see quantifiable improvements across cost, quality, and risk metrics within the first year.
Built for your organization
Purpose-built for the unique regulatory, financial, and clinical needs of every major population health stakeholder.
Medicare Advantage Plans
Stars improvement, RAF accuracy, member retention, MLR management, and CMS compliance reporting.
Commercial Health Plans
Network steerage, utilization management, and benefit design optimization across commercial books.
Self-Funded Employers
Stop-loss optimization, pharmacy carve-out insights, chronic condition management, and ROI reporting.
Municipal Health Programs
Population analytics for municipal and public-sector health programs covering employees and residents.
International HMOs
Risk, cost, and quality intelligence tailored for international payer organizations and managed care.
Provider Networks
Network performance, specialist utilization, and value-based contract execution across delivery systems.
Accountable Care Organizations (ACOs)
Shared savings performance, beneficiary attribution, and quality measure tracking for MSSP and commercial ACOs.
Independent Practice Associations (IPAs)
Network oversight, specialist utilization management, and PCP incentive alignment across independent practices.
Ready to see your population differently?
Schedule a personalized demo with our population health specialists. We'll walk you through your specific opportunity areas and show you how RAFIQ can transform your organization's performance.
Victor Behar
Call or text to schedule your personalized executive demo.
+1 (786) 271-3697+1 (786) 271-3697Miami, Florida
Available Monday – Friday, 9am – 6pm ET