Clarity Beacon · care-transition alerts
Know the moment your patient moves
The day a patient leaves your building, you stop hearing about them. Medicare keeps scoring you for another 30 days anyway. Beacon will close that gap: one clean alert when your patient shows up at another hospital or ED, with a named owner and a deadline, watched only as long as your care relationship lasts. A hard 31-day window after discharge, with auto-unsubscribe.
31-day window, hard auto-unsubscribeTreatment purposes onlyOne alert per real-world event
- For
- SNF, CCRC and ACO leadership
- Status
- Early-access cohort forming · built on rails Clarity operates in production
How Beacon will work
Catch, resolve, route
Three moves, from a raw signal to one alert with an owner.
- 01
Catch the signal
Three rails, in order of lead time. First, record-query detection on the nationwide networks Clarity operates on. When another organization asks the network about your patient, that question is itself the earliest signal, and it is the launch centerpiece. Second, the hospital event feeds federal rules already require, wired per market during your pilot. Third, events from Clarity’s own referral network.
- 02
Resolve the identity
Every raw event will hit the identity graph. One patient, many medical record numbers, one match, duplicates collapsed. Then the guardrail check: no active enrollment, no alert, and nothing is kept. An enrollment is the 31-day window after a SNF or CCRC discharge, or a roster seat for an ACO’s attributed members.
- 03
Route with a deadline
The rules engine will match team, population, event type and provider type, then deliver one alert with an owner and a clock. It arrives in the Clarity app, or as a text or email nudge that carries no patient details, or through a webhook.
Why it’s different
The alert that arrives before the admit
Think of it like a smoke detector versus a fire report. Traditional notification begins when an admit message exists, which means at or after the admission. Beacon’s query rail is designed to begin earlier, when another organization asks the network about your patient, while the disposition is still shapeable.
Awareness rail
Claims data
Typical time until the team knows
~90 days
What’s still possible when you find out
Nothing. Retrospective reporting only.
Awareness rail
Hospital admit notifications
Typical time until the team knows
hours after admit
sometimes next-day batch
What’s still possible when you find out
Discharge planning. The admit already happened.
Awareness rail
Beacon query signal
launch capability
Typical time until the team knows
minutes-scale target
often before an admit exists
What’s still possible when you find out
Shape the disposition itself: treat and return, in-network redirect, step up in place.
| Awareness rail | Typical time until the team knows | What’s still possible when you find out |
|---|---|---|
Claims data | ~90 days | Nothing. Retrospective reporting only. |
Hospital admit notifications | hours after admit sometimes next-day batch | Discharge planning. The admit already happened. |
Beacon query signal launch capability | minutes-scale target often before an admit exists | Shape the disposition itself: treat and return, in-network redirect, step up in place. |
Latencies are directional characterizations of each rail, not contractual commitments.
The moment to picture
Illustrative scenario · synthetic patient- 01Day 9 after discharge. Your patient walks into an out-of-network ED in the evening.
- 02The ED queries her record on intake. Beacon is designed to detect that query on the network.
- 03The identity graph confirms it is your patient and that her 31-day window is active.
- 04Your team is alerted with an owner and a deadline, before the admit decision.
- 05Outreach within the hour: care context, med list, disposition options. When the admit message arrives later, it folds into the same alert. No second ping.
The signal already exists
Since May 2021, hospitals have been required to send electronic admit, discharge and transfer notifications for emergency and inpatient events (42 CFR 482.24(d)). The rule mandates the signal. It does not deliver it to your liaison. Beacon is designed to close that last mile.
Most transition alerts arrive after the fact, once a discharge summary exists. Beacon’s query signal is designed to fire before the admit does.
The alert
One line your liaison can act on
Patient, context, event, provider, owner, deadline. Specific enough to run the play, short enough to read on the move.
Beacon alert · launch format
“Resident X (discharged 12 days ago, dx CHF) just admitted to St. Mary's ED. Liaison to call by 4pm.”— Clarity Beacon, concept
Stated up front
Guardrails are the feature
Monitoring will last exactly as long as the care relationship does, and not a day longer. Clarity notifies; your clinicians decide.
Treatment and care coordination only
Beacon will operate for patients with an active care relationship to your organization, under BAA. Never population surveillance, analytics or model training. We designed the guardrails before the feature.
A hard 31-day window, for a reason
Beacon will watch for 31 days after discharge, then unsubscribe on its own. That window brackets Medicare’s 30-day return rule exactly. A patient who returns to skilled care within 30 days needs no new qualifying hospital stay. Monitoring will end the day that logic does. A new discharge starts a new window. For an ACO, the relationship is the attribution year, reconciled quarterly.
- Day 0 · discharge
- Day 30 · Medicare return rule
- Day 31 · auto-unsubscribe
Declined referrals are never monitored
Decline a referral and that patient will never be enrolled. Every raw event will be checked against your active enrollments first: no active enrollment, no alert, nothing kept.
No patient details in the ping
Text and email nudges will say only that a time-sensitive alert is waiting. Patient details will render after sign-in, behind role-based access, or arrive through a webhook into the system you already run.
On Clarity’s production platform
Beacon will run on the platform Clarity operates under BAA today: encryption in transit and at rest, role-based access, hard tenant isolation verified in evaluation, and full audit logging on every view, alert and outcome.
Identity graph · in production today
Machine resolution, human action
The identity graph resolves hospital MRNs, SNF MRNs and network identifiers to one canonical patient. One real-world event will become one alert, not four duplicates or a missed match.
The machine resolves and will route. It never acts. Clarity notifies; your clinicians decide. Every alert will carry a named owner, an outcome and an audit trail.
Three audiences
What the heads-up is worth
The same alert, three different paydays. Each is an illustrative model a pilot replaces with your own baseline.
Skilled nursing
~$135k/yr
1 re-referral won per month × ~$11,250 per skilled stay
Win the re-referral
Readmits are referrals about to happen. When a patient you discharged lands in an ED, your team will hear in time to reach out, protect the 30-day window, and be the first credible yes. Winning one re-referral a month is ~$135,000 a year for a reference 120-bed facility, before counting readmission-rate and VBP-withhold protection.
CCRCs and life plan communities
~$110k/yr
half of ~19 leaked skilled stays recaptured × ~$11,250
Bring the resident home
When a resident admits to another hospital or ED, your liaison will know in time to start the return-to-campus conversation, before the packet ever broadcasts to outside SNFs. Recapturing half of a typical community’s leaked stays is ~$110,000 a year, and every stay kept on campus keeps the continuum promise behind it: we will know, and we will come get you.
The same recapture lever the CCRC page counts, seen from the alert.
ACOs and risk-bearing groups
~$11,600
per caught event · ~$400 visit vs ~$12,000 ED episode
Intervene in place
An attributed patient shows up in an out-of-network ED and your team will learn while the disposition is still shapeable, not 90 days later from claims. An intervene-in-place visit instead of the reflexive ED-and-admit path avoids ~$11,600 per caught event, with readmissions tracked as a first-class counter-metric.
Illustrative economics for the reference models (120-bed SNF · 350-resident community · 20,000-life ACO). Targets, not guarantees, and not audited customer results. The pilot replaces every line with your baseline.
Common questions
Asked first, answered first
The questions a compliance officer, a DON and a CFO ask before anyone asks for a demo.
Not yet. Beacon is in development and launching soon, and the early-access cohort is forming now. The infrastructure underneath it runs in production today: nationwide record connectivity, the patient identity graph, and the cited-AI document pipeline. Design partners get first access and shape the launch.
What runs today vs. what’s launching
In production now: nationwide record connectivity, the patient identity graph, the cited-AI document pipeline, and the team and workflow platform.
Launching with Beacon: query-signal detection, the alert rules engine, and routed delivery. Beacon is in development and launching soon. The early-access cohort is forming now, and design partners get first access and shape the launch.
See your own baseline, not our slide
The early-access design-partner program is forming now. Partners shape the alert types, plays and delivery channels, start with a shadow-mode pilot on their own discharges, and are first in line at launch.