Methodology.

A directory published by one of its own vendors has an obvious problem, so the rules it follows should be written down and checkable. These are the rules every page here follows, including the page about the publisher's product.

Every claim is sourced and dated

Vendor capabilities, awards, acquisitions, funding rounds, and pricing changes are drawn from public materials: vendor sites, press releases, KLAS announcements, CMS publications, and the Federal Register. Each profile links its sources with dates. If we cannot source a claim, we do not print it.

Picks by job

We assign no numeric ratings of our own, because a composite score invented by a competing vendor would be worth nothing. The directory names the strongest defensible fit for each buying job and otherwise lists all ten vendors alphabetically. KLAS's 2026 results came out the same shape: three winners for three different jobs.

External validation outranks vendor claims

Where an independent rating exists, such as a 2026 Best in KLAS award, we report it prominently, including for direct competitors of the publisher. Where a vendor's number comes only from its own marketing, including the publisher's, we say so.

Ownership is disclosed everywhere

This site is published by Pelica Health, Inc., maker of the Pelica Risk Adjustment Copilot, one of the ten vendors listed. The disclosure appears in the footer of every page, on the Pelica profile, in the picks section, and in the FAQ. Readers should weigh our perspective with that fact in hand. The named editor, the conflict of interest, and the vendor selection rules are set out on the about page.

Corrections are honored

Vendor positioning changes fast in this category. If anything here is out of date or wrong, email directory@pelica.com; we correct errors and stamp the updated date on the affected page.

What "risk adjustment software" covers here

The directory covers software used by Medicare Advantage plans, IPAs, MSOs, ACOs, and medical groups to document member conditions accurately under the CMS-HCC model: prospective point-of-care suspecting, retrospective chart review and abstraction, coding engines, RADV audit tooling, and platforms that combine several of those jobs. Pure billing or claims-processing tools are out of scope.

Inclusion is editorial. No vendor pays to be listed, and no listing is paid placement. Back to the directory →