Take Back Control of your Health Plan with HCRM’s Analytics

Our Predictive Analytics will help you improve member health and reduce overall costs.

Welcome to Health Cost & Risk Management, LLC

At HCRM, we are committed to helping improve the health and well-being of as many people as possible. Using our proprietary software, we predict clinical events and associated costs with various health outcomes at the member level. 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. 

HOW We Help

Healthcare Predictive Analytics

• Quickly and accurately identify and stratify the 20% of health plan members driving 80% of the future clinical risk and cost

• Receive truly actionable information to manage populations better. 

Target your interventions to enhance the health of your members.

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Clinical Outcomes and Reporting

• Create effective strategies that will deliver results to the plan members with specific clinical needs

• Track compliance with standards of care and drug adherence

Understand the cost drivers of the population

Receive automated monthly, quarterly, or annual reports to monitor outcomes with fewer resources.

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Healthcare Management

• Schedule and track calls and/or outreach efforts

• Create customized care plans for coaches/nurses

Assign “outreach” requests based on forecasted risk identification

Time documentation and patient notes

Allocate resources more efficiently and tailor outreach

Measure individual and program performance

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WHO We Help

Health Plan Analytics

• Leverage predictive analytics to analyze clinical and cost risks of prospective populations, anticipate future trends, manage risk and enhance decision making

• Use data analytics to identify individuals at risk for specific conditions and implement proactive strategies to prevent or mitigate health issues and reduce overall costs.

Streamline your processes with accurate identification of members with the highest potential for improvement and cost savings

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Provider Organizations

• Receive a 360-degree view of all care, not just what’s in the EMR.

• View all gaps in care, all drugs used by the patient, and other diagnoses and treatments.

The HCRM system allows you to accurately assess the clinical and financial risk of taking on the employer plan and pricing their services.

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Population Health Management

• Optimize resource allocation by precisely and efficiently identifying and stratifying the population for targeted and meaningful interventions while tracking outcomes and program performance.

• Maximize savings by targeting next year’s high cost members

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Utilizing AI-driven technology for personalized risk solutions.

Clinical Predictive Modeling

Our technology identifies member and group clinical and financial risks through clinical predictive modeling. It forecasts the likely clinical events arising from each individual's specific health conditions. It summarizes future claims costs in dollars as the primary measure of clinical risk. The forecasts and related metrics can quickly identify the high-cost members and conditions that can be addressed before claims are incurred.

Care Management Solution

HCRM offers an end-to-end solution from predictive data aggregation to risk profiling and care management workflows - everything needed to improve patient outcomes right at your fingertips with a single login. Our clients can implement strategies to act on the data driven insights that will impact overall cost with the least amount of resources.

Data Normalization and Validation

We strive for clarity and accuracy through data normalization, ensuring reliability by eliminating mistakes and formatting data for easy understanding and actionable insights. Thorough data validation, assessing integrity and structure, guarantees industry-leading accuracy across our reports.

Stop-Loss Reporting

Our Stop Loss reports safeguard against high-risk financial losses by identifying members with significant medical risks before claims are incurred. Now you can proactively address these risks and help maintain financial stability.

It’s Easy to Get Started

1. Learn More

Enter your email for an in-depth overview of the functionality and capabilities of the HCRM system.

2. Demo

Fill out our inquiry form to schedule a Demo and learn how the HCRM team can help your business thrive.

3. Questions?

Here at HCRM, our team of friendly experts are always happy to lend a hand. Reach out to us with any questions you may have.

Try Our Solution for Free

Are you interested in trying our solution out for free? HCRM will collect all medical and pharmacy claims to process through our AI driven predictive model to demonstrate the power of this actionable information.

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Population health data analytics

What Our Clients Say

Michael Mitchell
Michael Mitchell
HCRM is a great organization to work with. I've been working with HCRM for the past 17 years, and in my experience there is no stronger technology platform out there in the medical AI, predictive modeling space. Bill Bramble and the leadership team are dedicated to their clients and are constantly innovating to lead the next generation of predictive modeling tools. The application of of their technology is wide and broad from health systems, onsite clinic operators, care management/health improvement specialists, underwriting, payors,and healthcare finance professionals. Most importantly, the HCRM platform is intuitive, easy to navigate, and produces powerful actionable data to help solve the biggest challenges in healthcare today.
Melissa Sowers
Melissa Sowers
Easy to navigate systems and services.
David Chiappino
David Chiappino
My experience with HCRM has been outstanding! The data is well organized and insightful. The support team is knowledgeable and available. Frequent updates keep the user experience fresh and meaningful. I will continue to recommend HCRM to my colleagues!
Ron Janetzke
Ron Janetzke
HCRM has been a critical component in my work for the past 4 years that I've been working in the medical management space. Not only is their product top-notch, but the customer service of their people has exceeded my expectations!

News And Resources

Identifying Members Needing Intervention Prior To Projected Increase In Cost
How do you identify members at risk for future health problems? Some use projected cost in the next ...
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Health Cost Risk Management-HCRM
Health Cost & Risk Management (HCRM) announces a COVID-19 Report available to identify plan members who are at ...
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Impact Of Predictive Analytics
The Impact of Predict Analytics can be demonstrated in HCRM’s most recent enhancement called the “Playground” in Health ...
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HCRM is excited to announce our SOC 2 Certification. This certification reinforces Health Cost & Risk Management’s on-going ...
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Why Choose HCRM?

Accurate Predictions

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 in the accuracy of our forecasts. Your business could be benefitting from the best that modern technology has to offer.

Measuring Risks in Dollars

Risk analysis is only helpful if you can understand what it means. Here at HCRM, 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 understand risk in terms of dollars.

Staying Ahead of Rising Costs

As healthcare costs continue to rise, understanding and addressing future clinical and financial risks is imperative. With HCRM services, employers can limit or avoid the 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.

Schedule a Time to Chat With Our Friendly Team

Here at HCRM, we are dedicated to empowering our clients to foster employee health through cutting-edge predictive analytics. If you’re interested in receiving accurate data to move you towards affordable solutions, our team would love to support your journey.

Schedule a demo with our dedicated experts today to learn how our solutions can contribute to the success of your business.

Membership By Forecasted Risk Category

Membership By Forecasted Risk Category

Forecasted Risk Group Distribution

Forecasted Risk Group Distribution