Enhance Your Health Plan with Predictive Analytics
Our Predictive Analytics for healthcare will help you improve member health and reduce overall costs.
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HEALTH COST & RISK MANAGEMENT
At HCRM, we are committed to helping improve the health and well-being your employee population. Using our proprietary predictive analytics software, Health Risk Monitor (HRM), we predict clinical events and associated costs at the member and group levels. This advanced system forecasts healthcare spending, identifies at-risk members, and measures outcomes of health management or wellness programs.
Ultimately, we help you make informed decisions that improve the health of your members and reduce your spending.
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WHAT ARE HEALTHCARE ANALYTICS?
Healthcare analytics give benefits professionals unparalleled insight into hidden patterns and population health trends, and a data-driven view of how health benefit programs are impacting employee health, productivity, and costs.
Sophisticated data analytics also allows employers to understand what’s behind high utilization, engagement, and cost trends at an individual and group level within their group population.
However, these insights are only as valuable as the data you put in.
When decision making directly impacts employee health, you can’t settle for data that is just “good enough.” While there are multiple data analytics vendors available, it’s important to note that data quality standards and accuracy vary significantly.
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THE BENEFITS OF PREDICTIVE HEALTHCARE ANALYTICS
Our cutting-edge technology offers organizations of all sizes, levels of predictive analysis that used to be available only for large companies. With one of the most cost-effective systems available in the predictive analytics industry, you can experience benefits such as:
- Overall improvement in member health
- Generally lower annual claims cost for operations
- Easy access to electronic health records
- Improved patient outcomes with early interventions
- Identification of high-risk members
- Cost reduction through preventative measures
- Tracked member treatment and medication compliance
Ready to see how our technology will empower your organization with actionable insights?
WHAT WE OFFER
HEALTHCARE
PREDICTIVE ANALYTICS
Our industry leading healthcare predictive analytics system empowers organizations with advanced data forecasting to identify high-risk patients, optimize treatment plans, and reduce costs while improving overall member health.
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DATA NORMALIZATION
AND VALIDATION
Data Normalization is about predictive modeling. HCRM’s proprietary system transforms raw data received into a common data structure and performs extensive quality checks creating accuracy rates over 95%.
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CLINICAL REPORTING
& OUTCOME ASSESSMENT
Our interface automatically tracks cost drivers, risk trends, and treatment compliance to assess intervention effectiveness, while providing real-time insights.
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HEALTHCARE MANAGEMENT
SOFTWARE
As an add-on to our Predictive Modeling System, a comprehensive Care Management Module, provides coaches with care management tools to schedule calls, send texts and email, collect encounter data and generate billing and outcomes reports.
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STOP-LOSS
REPORTING
Our predictive modeling reports identify high-risk, high cost patients, probable shock-loss and clinical cost drivers that enable accurate renewals, proactive risk management, and real-time performance monitoring.
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WHY CHOOSE HCRM?
- Accurate Predictions
- Measuring Risks in Dollars
- Staying Ahead of Rising Costs
By utilizing the most advanced AI-driven Predictive Modeling and Forecasting available, HCRM can provide reliable data analysis for companies of all sizes. Our model is regarded as the most accurate claims-based model available in the healthcare market, meaning you can trust the accuracy of our forecasts. Your business could be benefiting from the best system that modern technology has to offer.
Risk analysis is only helpful if you can understand what it means. We recognize the need to quantify clinical and financial risks in dollars. We take pride in translating clinical risk into understandable and comparable measures, giving you a direct way to measure and manage risk.
As healthcare costs continue to rise, understanding and addressing future clinical and financial risks is imperative. With HCRM services, employers can limit or avoid high-cost claims with actionable information. We help you identify and understand the members and conditions that are driving your health plan costs so you can implement measures to close gaps in care, improve member health, and avoid future claims.
Ready to see how our technology will empower your organization with actionable insights?
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WHO WE SERVE
SELF-FUNDED
EMPLOYERS
Sophisticated data analytics provides employers with actionable information on the causes of high claims costs and utilization at the individual and group level, then employ solutions to better manage member health and costs.
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HEALTH INSURANCE
CONSULTANTS
HCRM empowers healthcare consultants with analytics to navigate insurance options, provide tailored, cost effective point solutions, and evaluate the impact of those program outcomes.
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INSURANCE COMPANIES WITH FULLY-INSURED PLANS
Healthcare analytics give benefits professionals unparalleled insight into hidden patterns and population health trends, and a data-driven view of health plan’s forecast loss ratios and risk trends and their impact on various aggregations of plans, e.g., by plan type, by broker/consultant, by underwriter, etc.
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STOP-LOSS CARRIERS
AND CAPTIVES
HRM’s predictive modeling helps stop-loss carriers and MGUs assess risk, predict high-cost patients, and optimize financial and clinical management. Captive insurance programs use HRM’s predictive modeling to forecast pricing, track performance, manage risk, and reduce costs through population health management.
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POPULATION HEALTH
MANAGEMENT TEAMS
HRM’s predictive modeling helps stop-loss carriers and MGUs assess risk, predict high-cost patients, and optimize financial and clinical management. Captive insurance programs use HRM’s predictive modeling to forecast pricing, track performance, manage risk, and reduce costs through population health management.
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HEALTHCARE PROVIDERS
HCRM integrates EMR and claims data to give healthcare providers a comprehensive view of patient care, enabling better risk management, contract negotiation, and proactive patient engagement.
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EMPLOYER CLINICS
HCRM provides employer on-site clinics with a complete patient profile, enabling data-driven, proactive healthcare intervention strategies that improve population health management and overall financial sustainability.
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HEALTH PLANS
HCRM’s predictive analytics help health plans assess risks, anticipate trends, and implement proactive strategies to reduce costs and improve outcomes.
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THIRD PARTY ADMINISTRATORS
HCRM equips third-party administrators with analytics for cost containment, population health management, stop-loss negotiations, and customized benefit plans.
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ACCOUNTABLE CARE ORGANIZATIONS
We offer comprehensive healthcare support with our cutting-edge care management for ACOs to help manage financial risks and track treatment compliance to enhance patient outcomes.
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