athenahealth today announced new AI-native capabilities in athenaOne®, designed to help healthcare organizations succeed in value-based care (VBC). By combining AI with one of healthcare’s most connected data networks in a single, unified platform, athenaOne helps organizations identify and address opportunities across the patient journey and make faster, more informed decisions.

“athenahealth is uniquely positioned to help organizations succeed in value-based care because of the scale of our network and the flexibility of our platform,” said Chad Dodd, vice president of product management at athenahealth. “AI is only as powerful as the data that fuels it, and our network provides access to one of healthcare’s richest data sets. Combined with an architecture designed to deploy AI rapidly and at scale, this enables us to help organizations adapt and thrive as the industry shifts toward value-based care.”

athenaOne’s AI-native platform embeds intelligence directly into the workflows clinicians, care teams, and quality leaders already use. This helps organizations strengthen risk adjustment, improve quality performance, increase opportunities for shared savings, and reduce unnecessary costs.

Embedded directly into athenaOne workflows, these AI-native capabilities support organizations across the spectrum of VBC:

  • Clinically Inferred Diagnosis Gaps, now in beta, uses AI to analyze patient chart data and surface undocumented diagnoses that may warrant review and evaluation. By presenting these conditions alongside supporting clinical evidence, the capability gives providers more complete information at the point of care to support care planning and documentation. Compared with suspected diagnosis gaps identified from other sources, clinically inferred gaps from athenahealth have a 2x higher closure rate and a 3.5x lower dismissal rate, helping support quality of care and appropriate Hierarchical Condition Category (HCC) capture.

“Busy providers often focus on the most clinically important diagnoses during a visit and may not have time to review the chart for every diagnosis or the most specific one. athenahealth surfaces inferred HCC diagnoses in the provider’s normal workflow in a non-obtrusive way, with the reasoning behind each recommendation and links to the full result or clinical note for review if needed. Providers can add the appropriate diagnosis to the note from the same screen, helping capture clinically important diagnoses that support value-based care initiatives.” – Dr. Scott Davis, chief medical information officer at Holzer Health System

  • Enterprise Care Management with AI-Suggested Goals and AI Care Event Summaries, now in alpha, uses AI to suggest personalized care plan goals that the care team can incorporate directly in the patient chart, helping save care managers time and support patient engagement. AI-generated summaries of hospital care events help teams quickly understand what happened and coordinate timely follow-up, supporting better continuity of care and fewer avoidable readmissions.

  • Data Explorer: population-level reporting, now in beta, helps clinical and administrative teams monitor performance against quality measures, identify care gaps, stratify patient populations, and access the relevant patient chart to review or document care. Embedded AI explains why a patient has or has not met a quality measure, enabling users to quickly understand measure status without manually reviewing complex clinical documentation.

  • Sage for Analytics, available now in alpha, uses athenaOne’s AI assistant, Sage™, to help value-based care teams analyze population data using natural language, generate real-time visualizations, track performance, and identify quality improvement opportunities. Agentic Care Gap Outreach, coming soon to alpha, will extend these capabilities, using agentic AI, to identify patients who need outreach and prepare tailored communications for customer review and approval before they are sent. It will also help teams monitor progress and prioritize next steps, helping teams close care gaps, and improve quality performance.

Together, these capabilities help organizations identify and address opportunities across the VBC journey, improving quality, strengthening risk adjustment, and supporting better financial performance. Learn more.

About athenahealth

Since 1997, athenahealth has been curing complexity for ambulatory healthcare practices and the patients they serve, empowering them to deliver the best possible care and business outcomes through innovative clinical, financial, and patient engagement solutions. athenahealth connects practices, health systems, payers, partners, and patients to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. Learn more at www.athenahealth.com.

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