Inpatient hospitalizations present care and cost management opportunities. Prospective notice of hospitalizations allows payers to implement care or steerage interventions aimed at improving the member’s clinical and cost outcomes. Aggregate, employer level projections of hospitalizations facilitate better financial decision making between the payer and client during the renewal process. Premera has created and routinely updates member level inpatient hospital predictions that are made available for use in both clinical and employer group underwriting decisions.
Describe the new knowledge and additional skills the participant will gain after attending your presentation.: Understand how machine learning can be applied to claims data to support care coordination, patient outcomes, and underwriting.
Adam Cornille (Presenter)
Premera Blue Cross
Giuliano Janson, Premera Blue Cross