3.8Mreadmissions
What comes back within 30 days.
3.8 million adult 30-day readmissions in the US in 2018, at an average cost of $15,200 each2.
Readmission rate: 14 per 100 index admissions2.
V3Qtor AG/Industries/Healthcare
Pay once, not twice.
Hospital groups and health insurers pay twice for the same gap: once when a patient comes back, and again when the claim takes weeks. We close the gap at the discharge and settle the claim in a day.
The levers
Where the cost of care gives way.
Readmissions and the claims cycle carry most of the bridge. Bedside time and prevention follow.
Cost-of-care bridge, provider and payer engagement
Index points on a baseline of 100. Illustrative.
Illustrative bridge1. Hover a bar for the lever behind it.
31%of a shift
Where nursing time goes.
Nurses spent 31% of a 12-hour shift in EHR flowsheets, by the vendor's own time data3.
$10B+a year
What fraud takes out of the system.
Health care fraud losses are estimated in the tens of billions of dollars a year4.
$15,200each
The unit cost of a gap in care.
The average 30-day readmission in 20182. Every one prevented is a bed, a nurse and a payment returned.
The numbers behind the sector
A readmission costs $15,200. A nurse spends 31% of a shift typing.
AHRQ, JMIR and NHCAA, cited in full below.
14per 100
30-day readmission rate
Fourteen adult readmissions for every 100 index admissions in 2018, 3.8 million in total2.
AHRQ HCUP Statistical Brief #278, 2021
31%of a 12-h shift
Nursing time in flowsheets
Measured from EHR vendor time data across four teaching hospitals; nurses self-reported 10 to 50%3.
JMIR Nursing, 2025
$10B+a year
Estimated health care fraud losses
In the tens of billions of dollars a year, by the industry's own anti-fraud association4.
NHCAA, Senate testimony, 2011
Use cases
What we run for providers, payers and value-based care.
Personalised medicine
Prevention priced, treatment matched, risk seen early.
Decision & Risk SciencesMy Health CompanionPersonal health assistant with escalation rules24/7with clear escalation rulesDecision & Risk SciencesTreatment OptimizerPrecision treatment matchingPer patienttreatment matched to the evidenceDecision & Risk SciencesHealth Risk PredictorPreventive health monitoring from wearables and biomarkers$8,500annual savings per person
Insurance cost optimisation
Risk priced, claims settled, fraud caught at intake.
Decision & Risk SciencesActuarial Risk EngineIndividual risk prediction for pricing and interventionPer policyrisk priced individuallyDecision & Risk SciencesWellness Rewards SystemPreventive-care incentives priced by outcome$3,200annual savings per memberOperations IntelligenceIntelligent Claims EngineClaims processing with fraud detection at intakeSame daypayment for clean claims
Value-based care
Outcomes tracked, transitions managed, populations stratified.
Operations IntelligenceValue Metrics SuiteOutcome-based care trackingPer patientoutcomes tracked, not visits countedOperations IntelligencePatient Journey OptimizerCare coordination across providersOneplan from discharge to follow-upDecision & Risk SciencesCommunity Health AIPopulation health management$12.4Mannual savings per 100k members
What we start from
The data a hospital group already holds.
Readmissions, documentation time and claims cycle are all in systems that already run. We read them, agree the baseline with finance and the medical director, and build from there.
- Admission, discharge and transferADT feeds from the hospital information system, with index admissions and 30-day returns.Readmissions
- Clinical documentation timeEHR audit logs: time in flowsheets and notes per shift, by ward and role.Bedside time
- Claims and codingDRG coding, claim submissions, rejections and payment dates from the billing system or the payer.Claims
- Scheduling and rostersNurse rosters, theatre schedules, outpatient slots and their actual utilisation.Capacity
- Medication and labPharmacy orders, reconciliation records and lab results, for the risk models.Prevention
- Member and provider master dataOne record per patient, member and provider across payer and provider systems.Master data
$15,200the average cost of one 30-day readmission in the US2
Every readmission prevented is a bed, a nurse and a payment returned.
The gap is almost always at the transition: the discharge letter that arrives after the patient, the medication that was reconciled on paper, the follow-up nobody booked. Closing it is coordination work, and coordination work can be measured.
AHRQ Statistical Brief 278, 2018 data
How it starts
What the first quarter looks like on a ward.
Thirteen weeks, from counting the readmissions to a run-rate on the ward’s board.
Weeks 1–3
Count the readmissions and the hours
We take the ward's own discharge, readmission and documentation data and price it: readmissions against the AHRQ unit cost2, documentation time against the JMIR share of shift3, claims days against your own cycle.
You get: one page per ward with the cost of its gaps
Weeks 4–8
Pick the ward and the lever
We start on one ward, usually with the discharge. Letters drafted from the record, medication reconciled, follow-up scheduled. Our engineers sit with the ward lead and the coding team.
You get: the first discharges with the letter ready at the bedside
Weeks 9–13
Run the ward from it
The weekly ward meeting starts from the readmission list, the claims queue runs from the validator, the clinician signs instead of types. The number goes on the ward's own board.
You get: a run-rate finance can read
Practices and systems in this sector
The practices and systems behind the work.
Decision & Risk Sciences
Risk scoring, treatment matching and prevention priced against the claim it prevents.
Operations IntelligencePatient flow, claims queues and care transitions mined from the records the system already keeps.
AI GovernanceOn-premise deployment, deterministic rules where a clinician relies on the output, every decision logged.
Master Data Management LayerOne member, one patient, one provider record across payer and provider systems.
Talk to us about a ward or a claims queue.
Tell us where the days go: readmissions, documentation or claims. We will come back with the ward or the queue we would start on, and what it would recover.
Notes and sources
- 1Illustrative. Anonymised engagement scenarios; figures indicate modeled or targeted impact and are not audited outcomes.
- 2Weiss AJ, Jiang HJ. Overview of Clinical Conditions With Frequent and Costly Hospital Readmissions by Payer, 2018. HCUP Statistical Brief #278, AHRQ, July 2021. 3.8 million adult 30-day readmissions, average cost $15,200, readmission rate 14 per 100 index admissions. Source
- 3Jacques D et al. Evaluating Nurses' Perceptions of Documentation in the Electronic Health Record. JMIR Nursing 2025;8:e69651. EHR time data showed nurses spent 31% of a 12-hour shift in flowsheets. Source
- 4National Health Care Anti-Fraud Association, testimony to the U.S. Senate HSGAC subcommittee, October 2011: financial losses from health care fraud estimated in the tens of billions of dollars a year. Source