Underwriting Risk Predictor

Harmonized clinical lab data delivers powerful insights that improve predictive risk assessment 10% better than demographic data alone.

Clinical insights factored in your risk underwriting can yield millions in cost savings.

Underwriting decisions affect net profit and cause mis-matched risk to premium so it’s critical to leverage every factor when predicting risk. Prognos’ secure, cloud based Underwriting Risk Predictor leverages the insights gleaned from over 250M lives to achieve a more accurate score. This is especially revealing when pricing group health plans without prior claims history.

Upon receiving a de-identified employer census, it is matched against our HIPAA and HITRUST compliant clinical registry where unique and highly-trained models produce a reliable risk score that captures clinically-based health insights to predict risk. Furthermore, Prognos’ predictive analytics delivers a risk prediction score for each employer group based on relative projected per member annual cost. Benefits include the ability to:

  • Address the lack of information on small and medium sized employer group members head on
  • Overcome the latency and limitations of medical claims 
  • Leverage the most current clinical member information including insights on their exact and most recent health condition, its progression and severity, and co-morbidities that impact prediction confidence 
  • Built on the AI-driven prognosFACTOR™ platform that harmonizes and enriches the clinical test results of over 250M lives
You can quickly get started because UW Risk Predictor is HIPAA compliant, secure, and easy to operationalize, returning risk scores in under 30 minutes

Easy to Implement

Underwriting Risk Predictor delivers a four-digit group level risk score that can be easily integrated into your risk calculations and help you set premiums that will give you greater confidence in pricing group health insurance cases.