Patient Risk Stratification
Risk scores and risk stratification techniques are foundational for any successful population health management program. VarMed has combined the efforts with several partners to provide solutions to accurately identify high-risk members/patients and determine the appropriate level of care and engagement. Our solutions provide a system to predict Inpatient utilization, overall costs, and use of services. Also, identifies future, concurrence, prospective member/patient risk scores; identify chronic conditions and treatment adherence; match predictive high-cost members, and; patients with efficient and cost-effective providers to improve outcomes.
High cost – high needs patient identification
Payers in the Puerto Rico health care system, particularly Medicare and Medicaid, are increasingly requiring health care systems, to alternative payment models that include financial risk. The success of health care systems participating in alternative payment models is based on their effectiveness in addressing the care and costs for HNHC patients. Although these patients represent a small proportion of the patient population, they account for a substantial portion of health care costs. VarMed’s state of the art data management and repository capabilities provide customizable alternatives to our clients for successful patient identification.