Success Story: How ConcertoCare reduced hospitalizations among high-risk populations with predictive analytics
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
How to help employer groups plan in a time of uncertainty
Employers and their sponsored health plans are thinking about next year’s benefit designs with a significant challenge not seen before: the effect of the coronavirus pandemic. There are important considerations to take into account before making any decisions about new or existing coverage. Becky Niehus, a director of Product Consulting at MedeAnalytics, explores these new issues and what employers can do to ensure employees are “covered.”
Read on...
Healthcare’s return to “normal” after COVID-19: Is it possible?
As providers determine how to get patients to return to facilities for routine disease management and preventive screenings, opportunities are ripe for the application of analytics to triage at the right time to the right setting. Data related to COVID-19 will continue to flow rapidly, but there are possibly more questions than answers now about a return to “normal.”
Read on...
Avoid COVID-19 modeling pitfalls by eliminating bias, using good data
COVID-19 models are being used every day to predict the course and short- and long-term impacts of the pandemic. And we’ll be using these COVID-19 models for months to come.
Read on...
Population Health Amid the Coronavirus Outbreak
In speaking with many colleagues throughout the provider and payer healthcare community, I’ve found an overwhelming sense of helplessness to the outbreak’s onslaught. This is exacerbated by the constant evolution of reported underlying medical conditions that indicate a higher risk of hospitalization or mortality for a coronavirus patient.
Read on...