Population Health Solutions

 

The evolution of shared risk arrangements between payers, providers and care managers has created the need for a comprehensive population health management strategy at multiple levels. Successful population health management requires intervention on a patient centric basis as well as the management of similar patients aggregated into populations. Management at both of these levels requires a three pronged approach: 1) data collection and integration from multiple sources, 2) risk stratification and predictive modeling to prioritize interventions, and 3) front-end operational applications and tools for care management and outcomes measurement. hMetrix offers highly customizable and secure population health management solutions for payers, providers and care managers.

Data Collection and Integration

Proper data collection and integration is critical toward developing successful population health management strategies.

Features:

  • Based on 2 decades of experience, hMetrix' fifth generation data collection, reconciliation and quality check processes identify and address potential issues in source data resulting in clean data that avoids misleading analytic conclusions and costly mistakes
  • hMetrix' state-of-the-art, high-performance Master Patient Index (MPI) software matches patients across disparate systems and resolves duplicate identities to reconcile errors and gaps in demographic data
  • Combined clean data from multiple sources is enhanced using risk scores, patient classification systems and care classification systems, before it is stored in an analytical database that is made available for different members of the administrative and care teams

Risk stratification and Predictive Modeling

hMetrix' patient-centric risk stratification process is based on objective assessment outcomes, an expert clinical system and predictive models that use machine-learning algorithms. The result is a significant return on investment from the appropriate allocation of resources and early aggressive management of patients with the greatest needs.

Features:

  • hMetrix has a unique package of assessments to define specific patient attributes and characteristics that have been proven to improve outcomes and reduce cost
  • Using expert clinical knowledge, the assessment is used to risk score each patient
  • The risk stratification process is enhanced using custom developed predictive models that incorporate other datasets such as administrative claims data, drug data, lab results and EMR data. These predictive models are based on advanced machine-learning algorithms
  • The risk scores assigned to the patient is used to stratify patients into groups within the population ranging from severe risk to low risk based on impactable risk factors. The risk groups are used to drive appropriate resource allocation and management prioritization

Front-end Applications and Tools

hMetrix offers a number of customizable front-end applications and tools that can be used by program managers for care plan development and management, reporting as well as for patient monitoring and education.

Features:

  • hMetrix' integration platform uses the data from the assessments and other sources to generate an automated care plan that provides baseline objective measurements for each patient in the population regardless of their level of risk. This plan can be used to coordinate and manage care and assess the effectiveness of the care interventions through re-measurement against the baseline measurements
  • The platform has customizable and user-friendly dashboards designed to provide information that is relevant to different members of the management team to assess their process components and outcomes