Predictive Analytics

It's no surprise that members/patients with complex health needs account for a large share of healthcare spending. Quickly identifying and engaging them 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.

Give your care and quality management teams easy-to-use predictive analytics to efficiently and effectively stratify and target high-risk members/patients to improve outcomes and lower costs.

Stratification by Projected Cost Dashboard

Stratification by Projected Cost Dashboard

The QualMetrix Predictive Analytics solutions enable care and quality teams to:

  • Review predictive indicators of future costs and use of services
  • Leverage predictive model tools to assess likelihood of admission, re-admissions, future medical and pharmacy costs, and other issues
  • Evaluate member/patient risk scores
  • Find members/patients that have high care coordination risks and take action
  • Gain insight into the chronic conditions of each member/patient to develop care plans and targeted campaigns
  • Match predictive high-cost members/patience with efficient and cost effective providers to improve outcomes