Care Management
Healthier members, through data-driven decisions.
We predict avoidables.
ER Visits
Admissions
Behavioral Health Admissions
Readmissions
Proactive. Not reactive.
Decision Point leverages machine learning to identify patterns and trends that drive member-level risk predictions, informing curated engagement strategies.
Pinpoint the right members.
We can identify the 5% of members who account for 50% of admissions. Casting a small, yet accurate net enables our clients to focus their resources on the members that will have the greatest impact on plan performance.
1.8
average ER visits avoided per member
16:1
average ROI annually
21%
average annual reduction in avoidable admissions
Members are complex.
Clinical data tells only part of the story.
Plans have a difficult time understanding how their members move throughout the world. Traditional healthcare data sources are necessary to build an informed engagement strategy but only provide a glimpse into the factors that are truly impacting a member’s well-being and health system engagement. We enrich plan data with consumer and census data sets to build deep, layered member profiles that allow our clients to better understand their members as people.
He...
lives with others
is a home owner
is a pet owner
lives 10 miles from PCP
is a college grad
Care Coordination
He...
lives alone
rents an apartment
has behavioral health issues
is unengaged with his doctor
Care Management
OPUS
An actionable member summary that supercharges engagement.
OurOpus Member Profile delivers an at-a-glance view of a member's historical experiences and predicted future behavior, enabling health plans to rapidly act upon critical intelligence.