One of the key issues that most ASOs, Health Plans struggle with is
1. Identifying high risk customers
2. Predicting probability of hospitalization and
3. Predicting future costs
VegaLytics Health has an integrated Risk Stratification model which predicts all the above and more. Jade’s out of the box Risk Stratification Engine leverages demographic data, diagnosis information and prior resource usage for your members. It also uses their pharmacy data to provide required indicators for population health management such as:
1. Member risk score
2. Hospitalization prediction scores
3. Care coordination risk scores
4. Pharmacy adherence risk scores
5. Total healthcare cost
6. Pharmacy cost
This serves as the guide for your case management team to focus on the high utilization, high risk members and improve the quality of care while reducing costs.