Clarify Health Solutions
Clarify Health Solutions, founded by Todd Gottula, is a healthcare analytics company focused on optimizing referral networks and care economics for health systems.
Profile
Helps hospitals keep patients within their network by analyzing referral patterns and optimizing care pathways.
Clarify Health Solutions, founded by Todd Gottula, is a healthcare analytics company focused on optimizing referral networks and care economics for health systems. The company's flagship product, Clarify Meridian, unifies referral intelligence, physician activation, and outcomes attribution into a single platform designed to reduce leakage and improve financial performance. With 60+ health system partners and a documented $3.2B in customer ROI, Clarify operates on an outcomes-based fee structure, aligning its incentives with client success.
Recent moves include the acquisition of Loyal Health in 2025 to enhance patient activation capabilities. The company holds CMS Qualified Entity (QE) status, enabling access to Medicare claims data for quality measurement. Clarify's 2024 public report analyzed hospital-level patient safety indicators across 300 million patient journeys, reflecting its data depth. Current focus areas include navigating CMS's TEAM model for value-based care and addressing the $1 trillion annual referral decision market where 30-50% of specialty referrals go uncompleted.
Who buys this
- Large health systems managing referral networks
- Hospital CFOs targeting margin improvement
- Value-based care strategy teams
- Managed care contracting teams
- Service line leaders in specialty care
Strengths and what to watch
Strengths
- Outcomes-based pricing model aligns fees with demonstrated client financial improvement
- CMS Qualified Entity status provides Medicare claims data access for quality benchmarking
- Acquisition of Loyal Health expanded closed-loop patient activation capabilities
Watch for
- Dependence on CMS policy changes affecting Qualified Entity data access
- Concentration risk with health systems representing core customer base
- Integration challenges post-Loyal Health acquisition in competitive patient engagement space
Recent moves
Key Information
- Founded
- 2015
- Headquarters
- San Francisco
Frequently Asked Questions
What does Clarify Health Solutions do?
Clarify Health Solutions helps hospitals optimize referral networks and care pathways using advanced analytics. Their platform, Clarify Meridian, integrates referral intelligence, physician activation, and outcomes attribution to reduce patient leakage and improve financial performance for health systems.
How does Clarify Health improve referral networks?
Clarify Health analyzes referral patterns to identify inefficiencies and optimize care pathways. Their platform provides actionable insights to keep patients within the network, reducing leakage and improving financial outcomes for hospitals and health systems.
What is the CMS TEAM Model, and how does Clarify Health support it?
The CMS TEAM Model is a value-based care initiative. Clarify Health offers strategic guidance and tools to help healthcare providers implement this model effectively, focusing on improving care coordination and financial performance through data-driven insights.
How does Clarify Health handle patient activation?
Clarify Health enhances patient activation through its acquisition of Loyal Health, which provides tools for closed-loop patient engagement. This helps ensure patients follow through with referrals and care plans, improving overall health outcomes.
What is Clarify Health's pricing model?
Clarify Health operates on an outcomes-based fee structure, aligning its incentives with client success. Fees are tied to demonstrated financial improvements, ensuring that clients only pay when they achieve measurable results.
What is Clarify Health's CMS Qualified Entity status?
Clarify Health holds CMS Qualified Entity status, granting access to Medicare claims data. This enables the company to provide quality benchmarking and performance measurement services, helping health systems improve care delivery and outcomes.
Sources
- clarifyhealth.com — Product capabilities and customer ROI claims
- clarifyhealth.com — CMS Qualified Entity status and quality measurement work
- clarifyhealth.com — Recent focus on CMS value-based care models
- clarifyhealth.com — Company background and leadership information