Expanded IRIS platform connects pre-encounter preparation (PEP), CMS submission tracking, and financial analytics to give PACE teams visibility across the risk adjustment lifecycle

NEW YORK, Oct. 06, 2026 (GLOBE NEWSWIRE) -- This press release replaces the release for IntusCare that was issued this morning at 10:00 am EST under the headline “IntusCare Upgrades Revenue Integrity System with Full Lifecycle Risk Adjustment Tracking for PACE Programs.” The corrected release follows.

IntusCare – a technology leader in 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 (PEP), the enhanced solution gives PACE organizations visibility across the full risk adjustment lifecycle. The enhanced platform connects clinical documentation, 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. By bringing these insights together in one place, IRIS helps organizations identify issues earlier and prioritize follow-up before key CMS deadlines pass. This gives organizations a more current view of risk adjustment performance and helps teams prioritize issues while there is still time to address them.

“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. Organizations that have used IRIS for more than a year have achieved an average RAF score increase of 0.091 in their 2025 final score when compared to their mid-year score.

“A change in a risk score or reimbursement is the starting point for an investigation, not the end of one,” said Malissa Bolish, director of risk adjustment strategy at IntusCare. “Teams need to understand what changed, why it changed, what the financial implications are, and whether there is still time to respond. We’ve expanded IRIS to help organizations answer these questions before documentation and submission opportunities are lost.” The enhanced IRIS platform will be generally available in November. Additional financial analytic enhancements expected in 2027 include cost data for margin calculations, revenue projections, and participant-level financial details.

About IntusCare
‍IntusCare is the only end-to-end ecosystem built specifically to help PACE programs deliver exceptional care, strengthen financial performance, and stay compliant. IntusCare replaces outdated technology and manual workarounds with purpose-built tools for care coordination, risk adjustment, population health, and utilization management. IntusCare empowers teams to take control of their operations and improve outcomes for dual-eligible seniors – some of the most socially vulnerable and clinically complex individuals in the U.S. healthcare system. Visit our website to learn more IntusCare.com.

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