IntusCare Upgrades Revenue Integrity System with Full Lifecycle Risk Adjustment Tracking for PACE Programs

Updated IRIS platform helps programs find and fix documentation, submission, and revenue gaps before CMS deadlines

NEW YORK, Oct. 06, 2026 (GLOBE NEWSWIRE) -- IntusCare – a technology leader in the Programs of All-inclusive Care for the Elderly (PACE) market – has announced the next generation of its Intus revenue integrity system (IRIS), which gives PACE teams an end-to-end view of risk adjustment data from a documented diagnosis through CMS submission and payment.

PACE organizations provide medical and social services to older adults who are aging in place at home. They receive a monthly Medicare payment adjusted for participants' health status, known as the risk adjustment factor (RAF) score, so accurate and timely documentation directly affects revenue. Traditionally, clinical, eligibility, and financial data have lived in separate systems, and teams relied on periodic reports to find errors. This process made it hard to connect a diagnosis in a clinical note to what CMS ultimately paid, or to catch problems in time to fix them.

First launched in 2024, IRIS was built to close that gap. It combines coding validation, risk adjustment analytics, and payment reconciliation support. The upgrade connects those stages and updates daily, so teams can see where a diagnosis or submission stopped progressing, understand how it may affect RAF and revenue, and know how much time remains to act before the CMS margin window closes.

“The new IRIS will provide a unified view that connects coding validation, risk adjustment analytics, and payment reconciliation through tracking across each stage,” said Nima Karamooz, vice president of product management at IntusCare. “With daily updates, teams can investigate where information stopped progressing and identify what needs follow-up without manually piecing together separate reports.”

IRIS empowers PACE teams to access data directly and investigate RAF scores to influence a better financial outcome. Through a daily dashboard, it monitors PACE program’s CMS pipeline and understands the coding language so that no condition, submission, or dollar could be missed. Over the past two years, IRIS has supported over 30 PACE organizations across the nation. All of these organizations that have been using IRIS for over a year have seen a 5% average improvement in RAF scores.

It is expected that this new version of IRIS will continue to drive improvements to RAF scores and other metrics as programs will have more visibility than ever into their operations and performance.

“A change in a risk score or payment is the starting point for an investigation,” said Malissa Bolish, director of risk adjustment strategy at IntusCare. “Teams need to understand what caused that change, whether it requires action, and how much time they have to respond. This upgrade is designed to help them answer those questions while there is still time to address documentation or submission issues with CMS.”

The upgraded version of IRIS is expected to be generally available in November, subject to beta testing results. 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 workaround 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.

Media contact:
Maddi Larsen
SVM PR & Marketing
intuscare@svmpr.com
(401)490-9700