"Medical and Pharmacy claims are analyzed through our award winning predictive modeling process. The comprehensive data analysis allows Predictive Health to forecast future health claims experience for the next 12-month period."
We implement solutions.
We’re not just a predictive modeling vendor, because Predictive Health implements solutions for our clients. We’re more than just a disease management company because our focus is on the entire patient, not just a specific disease. We’re more than just a utilization management company that reacts to situations because we take a proactive approach to managing health care. Our integrated approach allows Predictive Health to manage your specialty pharmaceutical costs in a manner that is cost-effective yet patient specific to make sure people get the care they need. We’re not just a wellness vendor, because we integrate employer and employee specific initiatives with day-to-day medical and case management.
Medical and Pharmacy claims are analyzed through our award winning predictive modeling process. The comprehensive data analysis allows Predictive Health to forecast future health claims experience for the next 12 months period. Data is continuallly updated on a regular basis. This allows Predictive Health to proactively initiate medical management interventions for plan members that are predicted to be at high risk for high utilization, hospitalizations and high claims costs. Once identified, we proactively work with patients to design and implement medical interventions that are specific for the patient. Our medical management processes engage the patient to become part of the solution, not to be treated as a problem.
It's all about doing the right thing.
With health care costs representing 8-10% or more of a company’s expenditures, and with those costs increasing yearly at double digit rates, employers need to rethink how to deliver health benefits. There have been no studies to prove that transferring increasing financial responsibility to the 15% of patients that drive 75% of health care costs helps to improve care. In fact, poorly designed benefit strategies may lead to patients not obtaining the medications that they need, leading ultimately to more days missed from work, increased numbers of emergency room visits, more hospitalizations, and ultimately more health care costs at the end of the day.
Predictive Health works with patients to develop an understanding about their medical conditions. When we identify opportunities to improve care using evidence-based medical guidelines, we work with the patient and their physicians to make sure people get the care that they need. And because we have integrated the medical management process, we continually monitor the claims to make sure that patients are remaining adherent and compliant with treatment recommendations. That’s a critical component in improving health and controlling costs over a long-term basis.