Data alone isn’t the most important aspect of a clinical risk management program.
Plano, TX (PRWEB) March 08, 2016
Predictive analytics for the healthcare industry continues to be big news. At this year's HIMSS conference, there were over 40 breakout sessions solely dedicated to the topic and it seems everyone wants to jump on the health analytics bandwagon - - even IBM is getting into the game by agreeing to buy a data company for $2.6 billion.
However, according to Jay Reddy, president and CEO of VitreosHealth, there are proven healthcare payer solutions that can help organizations save money while improving service; and attendees at HIMSS16 – and CEOs and COOs at insurance companies across the country – are missing them.
In VitreosHealth’s latest blog, it is revealed that the code to lower costs and better service has been cracked, and a regional payer in Oklahoma has the answers.
“We can now predict 70 percent of our hospital admissions,” said Scott Vaughn, CEO of GlobalHealth. “That gives us a huge opportunity to reach out in a very focused way to the people who need our services the most.”
This thoughtful approach to improving their member’s health has substantially benefitted both GlobalHealth and its members.
“We have had a 10 times return on our investment and the value we’ve gotten out of it in terms of reduced healthcare costs,” said Vaughn. “This year, we have an initiative in place where we plan to reduce healthcare costs by 10 percent. That would be about 25 million dollars in savings that we can then pass on to the members, use to improve healthcare benefits, or reinvest to help us deliver better service.”
As a regional payer, GlobalHealth didn’t want to massively overhaul its existing IT or organizational structure to start an analytics program. According to Vaughn, there were four key factors that helped his company realize these impressive results.
It may seem counterintuitive, but data alone isn’t the most important aspect of a clinical risk management program. The key is to understand how to turn that data into actionable outcomes that directly impact members.
“We partnered with a company called VitreosHealth,” said Vaughn. “Most health plans look at the members who have generated the most costs historically and focus on them. Whereas VitreosHealth, they look at those members as well, but they also identify members who haven’t generated high costs in the last 12 months but are very likely to have serious health complications in the near future.”
“We call that ‘insights as a service,’” said Reddy. “We sort through the data, say this is what it means, and these are the actions you can take to see results.”
With VitreosHealth’s assistance, GlobalHealth reaches its members and helps prevent major health issues from occurring.
Your organization can achieve perfect interventions with actionable data, to discover how click here.
VitreosHealth enables disruptive change in population health management. Vitreos Insights-as-a-Service delivers population risk models and predictive and prescriptive health insights so everyone throughout the healthcare continuum can achieve a patient-centric focus and contribute to financial performance. With VitreosHealth’s closed-loop performance management process, you can transform the business of population health management into a center of excellence to enhance clinical efforts and drive better health outcomes. Insights start with predictive clinical risk scores, non-clinical markers, gaps-in-care, and prescriptive care recommendations.
We show your care managers, clinicians, administrators and C-suite, which patients and members are going to become high risk, predict their probability of hospitalization or escalation of chronic disease, and help determine the interventions they need right now to delay or avoid high-cost healthcare episodes. Healthcare providers and payers choose the insights delivery method that’s right for their organization – mobile 3-click insights apps, embedded into the EHR or workflow system, or via other electronic format.
VitreosHealth Population Health Management powers all predictive and prescriptive analytics, leverages a comprehensive portfolio of disease-specific predictive risk models, and applies every source of data at your disposal: EHR, claims or billing, household, consumer, socio-economic and behavioral. VitreosHealth – everything you need to power population health management. Learn more at http://www.VitreosHealth.com.