Predictive modeling allows an employer a cost-effective solution to identifying members with chronic diseases as well as predicts health risks and cost by individual members.
The biometric screening information, Health Risk Assessment information, health claims data and Rx claims data are all integrated so that members receive valuable feedback from their individual Health Choices.
The Risk Navigator Clinical is a powerful predictive modeling tool that incorporates claims, pharmacy, HRA information and clinical data to:
- Predict Health Risk and Cost by Member
- Stratify Members into Risk Groups
- Focus on the Sickest, Most Costly Patients
- Minimize Shock Loss Costs
- Better Manage Total Claims Costs
- Increase Case Management Referrals based on Ambulatory and Pharmacy Claims Data
- Increase Case Management Referrals based on Actual and Projected Costs
- And...allow an employer to make educated changes to their plan to more toward Value Based Benefit Design!
