Population Health for Health Plans

The adoption of value-based reimbursement models is accelerating. Health plans like yours increasingly are turning to population health management strategies to thrive in this new environment. Our comprehensive suite of population health management solutions gives your health plan the tools it needs to effectively assess and manage the clinical and financial risk of your enrollee population in a specific geographic or contracted market.

Our cloud-hosted population risk management and health care analytics solutions use predictive modeling techniques to give your health plan the ability to stratify your members based on their health, clinical and financial risk factors. The solutions build health profiles of your individual members and performance profiles of your providers by aggregating clinical and financial data from multiple sources, including medical and pharmacy claims, into a single, comprehensive data warehouse. With our Intervention MessagingRx™ solution, your health plan can then identify members at high risk for hospitalization and make the necessary care interventions, such as better care coordination and improved medication adherence, to mitigate that risk. Your health plan also gains insights into the quality, safety and cost of care available at your contracting providers and can incentivize members to use only the most effective providers, and incentivize providers to improve their performance.

Successful population health management requires your health plan to identify and manage the clinical and financial risk of specific patient populations and specific provider networks. Our data-driven population health solutions will give you the actionable insights to achieve your goals.