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ConcertoHealth Implements MedeAnalytics Predictive Analytics to Guide Patient Interventions
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.
FREMONT, CA: MedeAnalytics, a healthcare analytics software-as-a-service (SaaS) leader, 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 percent improvement on Medical Loss Ratio (MLR) in 2021 and 20 percent improvement on MLR in 2022 after leveraging predictive modeling and analytics.
"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., the 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 percent, 40 percent and 16 percent, respectively."
ConcertoHealth incorporated 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.
"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 is apparent when the models are compared with the actual healthcare system and service utilization and costs following the intervention.