ConcertoCare (previously called Concerto Health) is a leading, risk-bearing provider of field-based complex care for vulnerable populations in California. By focusing on addressing social determinants of health, they apply data to effectively deliver high-touch, individualized care to create measurable impact.
The Challenge:
ConcertoCare came to MedeAnalytics with a few central business objectives:
- Address vulnerable populations
- Reduce hospitalizations for target groups
- Segment population groups for effective care management.
They also had big goals for growing analytics and reporting capabilities, including determining “impactable” populations for interventions, aggregating data for patient stratification and cost analysis, and obtaining actionable insights about vulnerable patient populations.
The Solution:
Our Population Health solution enables ConcertoCare to stratify risk and to assess cost and utilization patterns in the population to identify appropriate areas for intervention. More specifically, they:
- Use predictive analytics to impact the most complex 5% of the population and address rising risk in up to 20% of the population.
- Proactively look at Cost and Utilization patterns to identify and prioritize care and interventions for the patients who are the most vulnerable and most at risk.
- Categorize data by assigning Adjusted Clinical Groups (ACGs) to each patient based on morbidity, age and sex.
Measurable Impact:
ConcertoCare’s innovative population health analytics powered by MedeAnalytics substantially reduced hospitalization rates below the national averages for its Medicare patients.
- Admissions by 47%
- Readmissions by 40%
- ER visits by 16%
“We were able to significantly decrease unnecessary utilization for an entire population with MedeAnalytics’ predictive analytics.The insights allow the ConcertoCare home-based care team to intervene with patients to slow down disease progression and keep them safely out of the hospital, while uniquely addressing their myriad of complex care needs.”
– Dr. Chris Dodd M.D., Chief Clinical Officer
To read the full story behind the numbers, download the success story.
Get our take on industry trends
Employer reporting should prepare you for renewal long before renewal season
For many health plans, employer reporting still revolves around a familiar milestone: the renewal meeting. Teams assemble claims data, summarize…
Where Medicare Advantage revenue leaks: The disconnect between RAF, Star Ratings, and MLR
Most Medicare Advantage revenue loss doesn’t show up where finance teams expect it. It’s not a single variance in a report or a clear…
Becker’s Fall Payer Issues Roundtable: The Next Competitive Advantage Isn’t More Data. It’s Measurable Performance.
Healthcare payers have never had more data, analytics, technology, or AI available to them. Yet for many organizations, achieving meaningful…
Rural health transformation needs more than funding. It needs measurable results.
Rural health transformation succeeds when leaders can connect investments to measurable improvements in access, quality, cost, and sustainability. Doing so…
