Population Risk Management

Population-Wise. Patient-Centric.

Reduce risk, drive productivity, optimize revenue, reduce medical costs, and improve health outcomes. Use structured and unstructured data, drill down from the population to physician to individual levels, and see risk probabilities assigned to every individual for over 30 events and conditions.

Population Risk Management

Population-Wise. Patient-Centric.

Reduce risk, drive productivity, optimize revenue, reduce medical costs, and improve health outcomes. Use structured and unstructured data, drill down from the population to physician to individual levels, and see risk probabilities assigned to every individual for over 30 events and conditions.

Components of Spotlight Population Risk Management include:

 

The population overview and detail views allow the user to select and manage specific risk categories, such as risk of ED visit or development of diabetes. The user gets a full picture of the selection with a population risk distribution, incidence, prevalence, trends and benchmarking. Users can compare across systems, products, providers or geographies on a risk-adjusted basis.

Track, trend and improve quality and performance with population and individual views to close gaps in care or target specific performance measures like inpatient admissions or cost per admission. Select from HEDIS, MIPS or ACO, or create custom quality measures in addition to standard performance, cost and utilization reports.

Understand and manage revenue risk associated with CMS risk premiums, network leakage and episode payments using population reports and views. Additionally, HCC and RAF scores are tracked in individual profiles so that the user can easily identify and address data gaps and missing information.

 

Key social determinants of health, including things like homelessness, income, education, and access to food, transportation and care are included in the risk modeling and exposed to the user for discussion and intervention where applicable. Elements are represented in each individual’s profile as well as geographically in population views.

 

Clinical and Cost Risk

Population overview and detail views allow the user to select and manage specific risk categories, such as risk of ED visit or development of diabetes. The user gets a full picture of the selected risk with population risk distribution, incidence, prevalence, trends and benchmarking. Users can compare across systems, products, providers or geographies on a risk-adjusted basis.

Quality and Performance Risk

Track, trend and improve quality and performance with population and individual views to close gaps in care or target specific performance measures like inpatient admissions or cost per admission. Select from HEDIS, MIPS, ACO or create custom quality measures in addition to standard performance, cost and utilization reports.

Revenue Risk

Understand and manage revenue risk associated with CMS risk premiums, network leakage and episode payments using population reports and views. Additionally, HCC and RAF scores are tracked in individual profiles so that the user can easily identify and address data gaps and missing information.

Social Risk

Key social determinants of health, including things like homelessness, income, education, and access to food, transportation and care are included in the risk modeling and exposed to the user for discussion and intervention where applicable. Elements are represented in each individual’s profile as well as geographically in population views.

Clinical and Cost Risk

Population overview and detail views allow the user to select and manage specific risk categories, such as risk of ED visit or development of diabetes. The user gets a full picture of the selected risk with population risk distribution, incidence, prevalence, trends and benchmarking. Users can compare across systems, products, providers or geographies on a risk-adjusted basis.

Quality and Performance Risk

Track, trend and improve quality and performance with population and individual views to close gaps in care or target specific performance measures like inpatient admissions or cost per admission. Select from HEDIS, MIPS, ACO or create custom quality measures in addition to standard performance, cost and utilization reports.

Revenue Risk

Understand and manage revenue risk associated with CMS risk premiums, network leakage and episode payments using population reports and views. Additionally, HCC and RAF scores are tracked in individual profiles so that the user can easily identify and address data gaps and missing information.

Social Risk

Key social determinants of health, including things like homelessness, income, education, and access to food, transportation and care are included in the risk modeling and exposed to the user for discussion and intervention where applicable. Elements are represented in each individual’s profile as well as geographically in population views.

Key Features

Headlines

Past and future 12-month metrics including cost, quality and risk measures for quick comparisons.

Customizable Filters

Filter on any standard or custom attribute for maximum flexibility.

Risk Distributions

Full or selected populations distributed in meaningful ranges of probability for each risk for quick visualization and focus.

Risk-Adjusted Targets

Benchmark performance on risk- adjusted targets for better comparison and physician alignment.

Transparent Risk Features

Target interventions based on specific risk drivers using individual risk probabilities and weighted risk features for each event, cost or condition.

Workflow Integration

Worklists can be integrated with care management systems or EHRs and data can trigger workflows or rules in host systems.

Social Determinants of Health

Individual health risks associated with social determinants are exposed for discussion and non-medical interventions.

Heat Mapping

Data elements such as risk scores, disease incidence or social determinants can be displayed on geomaps.

Care and Coding Gaps

Supports HEDIS and MIPS measures and tracks HCC and RAF scores.

Solutions Proven in Research and Practice

Our proven risk management and analytics models give healthcare organizations the power to act on real-time insights to improve health at a lower cost.

Solutions Proven in Research and Practice

Our proven risk management and analytics models give healthcare organizations the power to act on real-time insights to improve health at a lower cost.