Predict & Mitigate Risk
It’s no surprise that members/patients with complex health needs account for a large share of healthcare spending. Quickly identifying and engaging them is a requisite for success but it can be challenging. Predictive analytics enable care teams to accurately identify high-risk members/patients and determine the appropriate level of care and engagement needed moving forward.
Give your care and quality management teams a nationally accepted predictive analytic model to efficiently and effectively stratify and target high-risk members/patients to increase quality and lower costs.
The Clinigence Health Predictive Analytics solution enables care and quality teams to:
- Identify the predictive indicators of future costs and use of services
- Identify the likelihood of admission, re-admissions, future medical and pharmacy costs, and care coordination issues
- Identify both concurrent as well as prospective member/patient risk scores
- Identify members/patients that have high care coordination risks and assign appropriate resources
- Gain insight into the chronic conditions of each member/patient to develop care plans and targeted campaigns
- Match predictive high-cost members and patients with efficient and cost effective providers to improve outcomes