RAAPID’s Explainable AI Wins Award, Sets New Bar for Healthcare Trust

LOUISVILLE, KY – January 13, 2026 – RAAPID Inc., a Louisville-based health technology firm, has been recognized by Modern Healthcare with a 2025 Best in Business Award for its groundbreaking clinical AI platform. The award, presented in the highly competitive Healthcare IT category, honors the company’s innovative approach to risk adjustment—a critical but often complex process in the healthcare industry. By leveraging a unique form of artificial intelligence, RAAPID is addressing one of the biggest challenges in modern healthcare: building trust in AI-driven decisions.

The recognition celebrates the company’s Novel Clinical AI Platform, which is powered by proprietary Neuro-Symbolic AI. This technology provides healthcare organizations operating under value-based care models with explainable, audit-ready risk adjustment, a feature that has become increasingly vital in a stringent regulatory environment. The award winners were officially announced in the January 12, 2026, issue of MH magazine.

The Push for Explainable AI in a High-Stakes Industry

For years, the adoption of artificial intelligence in clinical settings has been hampered by the “black box” problem, where AI systems deliver conclusions without revealing their reasoning. In an industry where decisions directly impact patient care and financial solvency, this lack of transparency has been a significant barrier. RAAPID’s platform directly confronts this issue by using Neuro-Symbolic AI, a hybrid approach that marries the pattern-recognition strengths of deep learning with the logical, rule-based reasoning of symbolic AI.

This combination allows the platform to not only identify potential Hierarchical Condition Category (HCC) codes from unstructured patient data but also to show exactly why each code is suggested. It creates a transparent, auditable evidence trail, linking every recommendation directly to MEAT-based clinical evidence (Monitor, Evaluate, Assess, Treat) within the patient’s documentation. This inherent explainability is what sets the technology apart and earned it recognition from Modern Healthcare, a brand widely considered a top source for business news in the sector. The Best in Business awards are judged by a panel of industry leaders who evaluate submissions on quality, outcomes, and efficiency, underscoring the significance of RAAPID’s achievement.

“We are proud to honor this year's recipients of Modern Healthcare's Best in Business Award,” said Dan Peres, President of Modern Healthcare. “These organizations demonstrate the progress, creativity, and quality that help move healthcare forward. Their innovative approaches and measurable impact are redefining what's possible in care delivery and operations.”

Delivering Measurable ROI in Value-Based Care

The shift from fee-for-service to value-based care models has placed immense pressure on healthcare organizations to accurately document patient risk. Proper reimbursement, resource allocation, and care management all depend on a complete and precise understanding of a patient population's health status. Inaccurate or incomplete coding can lead to significant revenue loss and compliance risks.

RAAPID’s platform is demonstrating its ability to turn this challenge into a strategic advantage. According to the company, its retrospective risk adjustment solution has delivered remarkable outcomes for health plans. One multi-state plan, for example, achieved 98.5% coding accuracy while realizing a return on investment of more than ten times its project costs. The solution also dramatically improved operational efficiency, reducing chart review time by 75% and enabling the plan to complete 100% of its reviews in weeks instead of months.

The platform's prospective capabilities are equally impactful. By analyzing up to two years of patient data from disparate sources like medical charts, claims, and lab reports before a patient visit, the system surfaces chronic conditions that need to be recaptured and identifies suspected emerging conditions. A multispecialty medical group using this pre-visit solution reported efficiency gains of 50% to 60% in its pre-care workflows, coupled with significant revenue recovery from previously missed diagnoses. Similarly, a multi-state, provider-owned payer achieved 60% to 80% faster chart reviews and a 25% increase in coding accuracy, also reporting a 10x+ ROI.

Navigating a Shifting Regulatory and Investment Landscape

The timing of RAAPID’s innovation is critical. Federal regulators, particularly the Centers for Medicare & Medicaid Services (CMS), are intensifying scrutiny over risk adjustment data. The final Risk Adjustment Data Validation (RADV) rule empowers CMS to extrapolate audit findings and reclaim substantial overpayments, making audit-readiness a non-negotiable requirement for health plans. Solutions that provide clear, defensible evidence for every code submitted are no longer a luxury but a necessity for survival.

RAAPID's HITRUST-certified platform, with its emphasis on explainable AI and transparent documentation, is positioned to meet this demand head-on. This market alignment and technological promise have not gone unnoticed by the investment community. The company is notably backed by M12, Microsoft’s venture fund, a partnership that serves as a powerful endorsement. This investment connects RAAPID to Microsoft’s broader, aggressive strategy to embed AI throughout the healthcare ecosystem, from clinical trial matching to automating administrative tasks. The backing from M12 validates RAAPID’s approach and provides it access to the vast resources and technical expertise of one of the world’s largest technology companies.

“This recognition reflects the tireless work of our team to solve one of healthcare's most difficult challenges: achieving accurate risk adjustment at scale,” said Chetan Parikh, CEO and Founder of RAAPID. “Every day, we see the burden that manual processes and fragmented data place on healthcare organizations. Our Novel Clinical AI Platform was built to deliver audit-ready accuracy while giving clinical and administrative teams their time back. Being named among Modern Healthcare's Best in Business validates our mission to transform risk adjustment from a source of anxiety into a source of confidence.” As healthcare continues its journey toward data-driven, value-based delivery, technologies that foster trust and deliver verifiable results will undoubtedly lead the way.