Pulse
Choose the right provider partners
Benchmark ACOs, practices, and facilities on cost, utilization, and quality.
For health plans, PACE organizations, and risk-bearing providers—and the patients they serve.
Falcon brings claims, contracts, member data, and CMS rules into one platform. Its AI surfaces the care, payment, and revenue issues your team should act on next.

Built by a former CMS staff member, two PhD scientists, former Astrana Health executives, and a former Harvard researcher.
Every finding traces back to the data, the method, and the policy behind it.
Pulse
Benchmark ACOs, practices, and facilities on cost, utilization, and quality.
Sentinel
Follow a billing signal to a documented case, backed by claims patterns and Medicare coverage policy.
Scope
Reconcile enrollment, encounters, risk adjustment, and payments across 70+ CMS files, member by member.
Helm
Attribution, quality measures, and prioritized worklists for ACO and risk-bearing teams.
More hospital visits? A billing problem? Patients missing follow-up? Falcon helps you follow the evidence across care, claims, and payments—then decide what needs attention.
The Falcon products
Population health, claims investigation, provider intelligence, and Medicare Advantage operations—with healthcare expertise, benchmarks, and repeatable workflows built in.
Evaluate provider partners
Compare provider and ACO performance, investigate utilization patterns, and evaluate network partners with market and benchmark context.

Find preventable spend
Investigate suspicious billing and potential overpayments with claims patterns, provider research, and Medicare coverage evidence for your team to review.

Run Medicare Advantage data operations
Manage encounter submissions and reconcile enrollment, risk-adjustment, and payment data so your team can find discrepancies that put Medicare Advantage revenue at risk.

Manage population health
Identify care gaps in high-risk populations, track quality and utilization, and create follow-up lists with the member and provider context your team needs.

How it works
When spending rises, check whether the cause is incomplete data, changes in care, or unusual billing. Keep the supporting evidence with the investigation, then create reports, chase lists, and scheduled monitoring for your team.
Bring MA data, financial and claims context, and the business definitions your team already trusts into one foundation.
Ask an urgent operational or savings question and trace it across the data, analysis, and supporting evidence.
Turn findings into case files, reports, and follow-up lists. Reuse trusted methods and schedule monitoring so your team can track changes over time.
Falcon foundation
Context, methods, Skills, memory, and governed AI
Talk to us
We’ll answer it with your data in a 30-minute call.