Webinar: A More Rounded Approach to Managing Risk: How a top payer uncovered member risk and improved ROI

Webinar: A More Rounded Approach to Managing Risk: How a top payer uncovered member risk and improved ROI

A data-driven risk adjustment approach is a no brainer. Payers can elevate their program to another level by utilizing clinical lab analytics with disease severity in addition to traditional data sets, like claims or Rx. . We’ll also discuss the potential of AI in improving risk adjustment programs. .By including a front-end AI prediction on the confidence factor that an HCC will exist in chart increases the effectiveness of the program. With the demand for value-based care, clinical lab results with its clinical specificity should be leveraged by both payers and clinicians for optimal risk adjustment. Hear from Dean Ratzlaff, Managing Actuary, Optima Health and Frank Jackson, EVP, Payer Solutions, Prognos Health on how utilizing clinical lab results can help find 15% more HCC’s than claim-based methods and how effectively identifying risk requires disease severity which is reflected in clinical data.