Healthcare Predictive Analytics
Healthcare analytics can be used to improve member health and enhance your long-term financial future.
Healthcare Management using Healthcare Analytics
Members with chronic illness consume more than 85% of health care costs, especially those with uncontrolled disease. Identifying these members to target for intervention can improve their health and bring your costs down. However, current costs do not necessarily predict future costs, so how do you identify members with future health and cost concerns?
Healthcare predictive analytics uses historical data and claims integration to forecast future healthcare trends, member claims costs and risks and to identify members who are non-compliant with national standards of care. Predictive analysis can improve member health and reduce overall costs for healthcare organizations.
Predictive healthcare analytics is for anyone looking to identify high-risk patients, improve treatment plans, track outcomes, and improve overall quality and cost reduction of health plans.
HCRM Data Collection, Normalization and Validation
Clients provide HCRM with appropriate contacts at their carrier/TPA and PBM. HCRM will contact them to request historical data and a monthly file feed. Upon receiving the data, HCRM's team meticulously validates each data point, ensuring the integrity and reliability of the data. This process involves identifying errors and concerns, such as missing or inconsistent data, and rectifying them to ensure the highest data quality. Following validation, we employ a sophisticated data normalization process, which involves integrating data from hundreds of different data sources into a common national dataset. This allows companies of any size to participate and keeps costs down for the client.
After normalizing and validating the data, HCRM leverages a powerful predictive modeling system using algorithms and advanced AI technology. This system provides invaluable insights, predicting member clinical events, risks and costs, and compliance with professional standards of care. Our user-friendly interface, Health Risk Monitor (HRM), is designed to be intuitive and easy to use, allowing clients to identify and stratify the population by demographic and clinical risk metrics with ease. Clients can also receive a monthly data feed containing forecasting and claims data for custom reporting.
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 the most cost effective system available in the predictive analytics industry, you can experience benefits such as:
- Overall improvement in member health
- Generally lower annual 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
Why Choose HCRM?
Accurate Predictions
By utilizing the most advanced AI-driven Predictive Modeling and Forecasting available, HCRM provides reliable data analysis and predictions for individual members and the health plans of any size. 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
Measuring Risks in Dollars
HCRM has a unique approach to clinical risk assessment – in dollars. This allows us to accurately and efficiently identify the 20% of health plan members who will drive 80% of future clinical risk and claims cost. Now you can easily see likely changes from the prior year and identify cost savings opportunities
Staying Ahead of Rising Costs
Clients can stay ahead of increasing claim costs and clinical risks by understanding which members and what conditions are driving those outcomes. They can then implement strategies and programs to close gaps in care, improve member health and avoid future claims.