Identifying high-risk patients and providing in-home care achieves broader population health goals
Richardson, Texas – (September 9, 2020) – MedeAnalytics, a healthcare analytics software-as-a-service (SaaS) leader, today announced that ConcertoHealth®—the nation’s leading risk-bearing provider of in-home, field-based complex care for high-cost and rising-risk populations—is projected to help health plan partners achieve 10% improvement on Medical Loss Ratio (MLR) in 2021 and 20% improvement on MLR in 2022 after leveraging predictive modeling and analytics. Combining MedeAnalytics’ Population Health solution with John Hopkins ACG® System for risk scoring helped ConcertoHealth identify and close patient care gaps and improve outcomes for a managed Medicare Advantage population.
ConcertoHealth implemented MedeAnalytics’ solution with the ACG® System add-on to assess cost and utilization patterns within its population. The solution uses predictive algorithms to forecast possible future outcomes for patients based on retrospective and prospective risk scores, which helps stratify risk and identify clinical intervention opportunities.
“We were able to significantly decrease utilization for an entire population with MedeAnalytics’ predictive analytics. The insights allow ConcertoHealth’s home-based complex care team to intervene with patients to slow down disease progression and keep them safely out of the hospital,” said Chris Dodd, M.D., chief clinical officer of ConcertoHealth. “With deeper analytics and insight, we have been able to push our hospital utilization, readmission rates and emergency room visits below the national averages for Medicare patients by 47%, 40% and 16%, respectively.”
“Improving the quality of care and reducing costs is a top priority for the healthcare industry, and ConcertoHealth has proven its ability to drive change,” said Paul Kaiser, chief executive officer of MedeAnalytics. “Healthcare organizations can look to ConcertoHealth’s success with its data-driven approach as a model they can implement to improve their population health management programs.”
By combining predictive solutions within MedeAnalytics’ platform, ConcertoHealth focused on care within high-risk and rising risk populations. Key statistics included:
- probability of hospitalization in the next 12 months;
- prediction of most costly patients; and
- probability of serious conditions and ICU stays.
The reduction in costs, utilization and mortality are apparent when the models are compared with actual healthcare system and service utilization and costs following intervention.
MedeAnalytics’ Population Health solution is part of its Value Based Performance Management portfolio. It offers insight into clinical quality, utilization and costs associated with patient populations and integrates closely with a broad array of health information exchanges (HIE) and provider-facing clinical workflow partners to provide a comprehensive population health management platform.
Read the case study to learn more how ConcertoHealth reduced hospitalizations with predictive analytics.
ConcertoHealth Inc. is the leading risk-bearing provider of field-based complex care for persistently high-cost and rising-risk populations. The company’s multidisciplinary care teams meet patients where they are, with the care they need, whether in the home or hospital. The ConcertoHealth care model improves overall health quality and outcomes with a track record of reducing hospital admits by 47%, readmits by 40% and ER visits by 16% for the most frail and vulnerable populations in America, benefiting patients, payers and provider networks alike. The company is headquartered in Aliso Viejo, California, and can be found online at concertohealth.com.
The Johns Hopkins ACG® System, ACG®, ADG®, Adjusted Clinical Groups® are registered trademarks of The Johns Hopkins University.