“Our team was immediately impressed by IRIS. From the real-time feedback to the focus on accurate, ethically sound diagnosis. It’s a well-organized, cutting-edge PACE risk adjustment solution that made our decision easy. Just as important, the IntusCare team has been incredibly responsive and collaborative from day one. You can tell they’re in it with you, and that gives us real confidence moving forward.”
Background
Facing increasing complexity in risk adjustment, Great Lakes PACE sought more than just a tool; they needed an intuitive platform that could not only ensure appropriate and accurate reimbursement but also embed ethically sound, defensible coding practices directly into their workflow.
After reviewing a demo of the Intus Revenue Integrity System (IRIS), the team saw immediate potential to transform their risk adjustment operations. The platform’s AI-powered real-time insights, its capacity for proactive identification of coding gaps, and its unwavering commitment to accurate, audit-ready diagnosis capture immediately stood out.
“The options IRIS gives you to see issues in real time really stood out to our providers—they felt it could make a meaningful difference in capturing data more accurately. And what resonated with us as a leadership team was the emphasis on accuracy. It’s not just about maximizing reimbursement—it’s about getting it right. And that’s a big reason why we moved forward.”
Two additional factors helped seal the decision:
- IRIS’s design for seamless integration with CareHub EMR creates a continuous, efficient workflow that will simplify documentation, coding, and submission once Great Lakes transitions later this year.
- The proven PACE-specific experience IntusCare brings, blending clinical, coding, and operational knowledge rooted in the PACE model. Great Lakes felt they weren’t just getting a vendor; they were gaining a true partner, invested in their ongoing success.
Challenges
Like many PACE organizations, Great Lakes faced increasing complexity around risk adjustment. Their key challenges included:
- Delayed visibility into documentation issues, making timely corrective action difficult.
- Fragmented ownership across roles without shared accountability for risk adjustment accuracy and outcomes.
- Adapting to CMS model changes like the shift to v28), without support and implementation guidance.
- Recapturing chronic conditions annually increasing the risk of missed diagnosis.
- Balancing accuracy with compliance without over-coding or under-documenting.
- Limited audit visibility with retrospective, sample-based reviews instead of comprehensive insight
Impact
Since implementing IRIS, the enthusiasm of Great Lakes staff has been impressive, helping to accelerate adoption. Notably, rather than limiting risk adjustment involvement to providers alone, Great Lakes opted to engage the entire interdisciplinary team in training and onboarding. The entire team attended the in-person training sessions, asked thoughtful questions, and engaged deeply to better understand their role in documentation and risk accuracy.
“The Great Lakes team has been incredibly proactive. They brought their entire interdisciplinary team into the process from the beginning—not just providers—which creates a shared understanding and accountability. That kind of engagement leads to better understanding and better outcomes.”
Malissa Bolish, Director of Risk Adjustment, IntusCare
Even for team members experienced in risk adjustment, the training made a lasting impact. IntusCare’s experts broke down complex topics in a way that truly resonated.
“I wasn’t looking forward to attending this training session, but it’s the first time in two years that anything presented on risk adjustment has made any sense.”
While full long-term financial outcomes will be reported in the future, immediate operational and strategic improvements include:
- Strong cross-functional engagement and rapid solution adoption
- Proactive identification and correction of coding gaps at the point-of-care to reduce missed diagnosis opportunities
- Comprehensive audit readiness with twice-yearly audits of 100% of charts
- A foundation for seamless integration with CareHub EMR, which will be implemented later this year
Thanks to IRIS’s advanced AI features, holistic design, and IntusCare’s expert partnership, Great Lakes now has a clearer, data-backed path toward optimized risk adjustment and enduring compliance integrity.
The Great Lakes Team learns how they all contribute to Risk Adjustment optimization.
Conclusion
By pairing a cutting-edge platform with a collaborative implementation, Great Lakes PACE is redefining what operational excellence in risk adjustment can look like. Their experience demonstrates that when the whole team is involved and training is tailored to meet people where they are, real, measurable results follow.
Interested in learning how IRIS can support your team’s success? Let’s talk!
