Athenahealth is developing several features in its athenaOne EHR designed to help healthcare organizations succeed in value-based care programs.

The company said the features are already in testing with thousands of providers working in a wide variety of value-based care initiatives. 

In a 2024 interview with Healthcare Innovation, Susan Albano, M.B.A., CEO of Prime Healthcare, an 80-provider multi-specialty physician group based in West Hartford, Conn., explained why she thought switching to athenahealth’s EHR would  help her practice fully embrace the value-based care environment.

“The biggest thing for us is that we fully embrace the value-based environment, so all of our contracts now have upside and downside risk. From my perspective as a practice leader, there are really three main components of succeeding in value-based care,” Albano said. “The first is provider engagement. You need to have providers who are willing to work in this environment. The second is you have to have good contracts with the payers. But the third, and really the most important to optimize your experience, is you have to have access to data — usable, reliable, available information that will help us manage our patients. Athena was our best option for that.” 

Now Boston-based athenahealth is expanding its arsenal of value-based care-focused tools. The company said its Clinically Inferred Diagnosis Gaps feature, now in beta, uses AI to analyze patient chart data and surface undocumented conditions that may warrant review and evaluation. By presenting these opportunities alongside supporting clinical evidence, the capability gives providers more complete information at the point of care to support care planning and documentation. 

The company quotes Scott Davis, M.D., M.B.A., chief medical information officer at Holzer Health System, about this feature: “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,” he said. “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.”

Another feature set, Enterprise Care Management with AI-Suggested Goals and AI Care Event Summaries, now in alpha, uses AI to suggest personalized care plan goals directly in the patient chart. 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.

A Data Explorer tool providing 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, the company said. 

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, which will be available in alpha soon, will extend these capabilities by using agentic AI to identify patients who need outreach, initiate tailored communications, monitor progress, and prioritize next steps—helping teams move from insight to action, close care gaps, and improve quality performance.

“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, in a statement. “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.”