POPULATION HEALTH INSIGHTS
Healthcare costs are rising, to bend that curve, you need to analyze and understand the health and care of your populations. RBI Population Health Insights accomplishes this through a combination of data integration, advanced analytics and population health program management expertise.
On a strategic level RBI Population Health Insights automatically stratifies your population, to identify prevalent diseases and cost drivers, to predict hospitalization risk, evaluate providers performance and even adjust capitation rates. Appropriately segmented, our advanced analytics inform the most appropriate interventions to improve your population’s health, impact your healthcare costs and to drive improvements in risk score accuracy and quality.
POPULATION HEALTH MANAGEMENT CYCLE
IDENTIFYING PATIENTS IN YOUR PROGRAM
Creating a comprehensive profile for every patient that considers their overall health is the first step in building an effective population health program. RBI Population Health Insights leverages the power of the Johns Hopkins ACG system to create a comprehensive risk profile for each and every patient based upon claims, enrollment, social determinants of health information and other information that we load into our system. This data is then aggregated at the population level to provide a comprehensive picture of how resources and costs are being consumed across your system, and to predict future utilization and costs that then drives targeted intervention programs to manage each individual patient's needs.
CARE GAP DISCOVERY
RBI Population Health Insights' care gap identification process, leverages the power of the Johns Hopkins ACG system, using diagnosis codes found in patient Medical and Rx claims, EHR data, and Enrollment information, to build a holistic picture for every patient.
RBI Population Health Insights produces a series of risk factors and risk scores that are assigned to each and every patient. Our risk score algorithm is configurable providing the kind of flexibility that is needed, depending upon the application and or population that we are working with.
Patient profiles, containing care gaps are updated each time the data in the system is refreshed, and are used throughout the system to inform statistical analysis, population health management programs, finance and budgeting, patient care programs and many other applications.
POPULATION STRATIFICATION
RBI Population Health Insights includes built-in tools for stratifying your population according to risk. High risk and emerging risk patients are identified as priority groups for coordinated care and disease management interventions, while low risk patients can benefit from wellness and education programs. This proven strategy results in quantifiable improvement in both clinical and financial outcomes.
PROVIDER AND PATIENT ENGAGEMENT
RBI Population Health Insight's Provider Reporting tools look at the case mix of a patient population and allows you to compare providers performance. P3Insights helps by identifying over and under-utilization of health care services that doesn’t match the morbidity risk of a patient population.
Provider Engagement is supported through our analytically driven reports and insights for primary care providers
Providers are on the front lines of patient care, RBI Population Health Insights' advanced Provider Engagement toolset is proven to have a positive impact on the programs that matter to our clients the most. Contact us to learn how.
CARE MANAGEMENT
RBI Population Health Insights facilitates Care Management in a number of important ways. Through our stratification process, patients who are Very High Risk are identified as people with often multiple, chronic diseases and complex health and social care needs who frequently use hospital and emergency services. High to Moderate Risk, are people with chronic diseases and sometimes complex health and social care needs, who are at risk of hospitalization but who could be managed in the community. Whereas patients who are Low to Very Low Risk, are people in the general population, who are relatively healthy and can be active participants in managing their own care.
RBI Population Health Insights can be integrated with existing Care Management platforms, providing informed, concurrent and predictive insights into the who, why and when your patient population is shifting over time.
Measuring Outcomes
Planning, measuring and continually adjusting resource usage is critical to the health of your business. RBI Population Health Insights' invaluable tools for finance, budgeting, and resource allocation allow you to:
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Estimate patients’ predicted resource use by condition category
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Calculate equitable payment rates to providers or health plans based on population case-mix
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Anticipate staffing and resource needs based on population risk factors and case-mix distribution
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Identify opportunities to reduce waste, inefficiencies, and redundancies contributing to high operational costs
HOSPITALIZATION
RBI Population Health Insights automatically identifies patients utilizing inpatient/outpatient services. The system creates a profile for every patient that not only focuses on historical utilization, but also creates a predictive score for those most likely to require hospitalization in the next 6 to 12 months. RBI Population Health Insights' informative dashboards and reports provide actionable information to reduce readmissions, drive targeted outreach and better intervention results.
RBI Population Health Insights analytics can be available at the point of care and are need not only be retrospective in nature.
EMERGENCY ROOM
ED visits for non-urgent conditions strain limited health care resources, incur unnecessary health care costs, and contribute to suboptimal care coordination. RBI Population Health Insights can identify and address these potentially avoidable visits, to streamline access to health services for patients. RBI Population Health Insights classifies ED visits into more granular categories, permitting the quantification of trends by patient type, chronic disease, and provider subgroup. The system easily identifies patients who have ED visits for non-emergent or PCP-treatable diagnoses.
Ultimately, this classification system reveals visits that could have been addressed at a lower level of care.
PHARMACY UTILIZATION
Understanding Pharmacy utilization in your population has many benefits. When combined with clinical information, pharmacy data in RBI Population Health Insights gives you a better, more holistic view of your patient's overall health.
RBI Population Health Insights' comprehensive suite of pharmacy-driven markers work alone or in combination with clinical diagnosis indicators to highlight medication use, opportunities for cost optimization, and to predict future costs and utilization
PREDICTIVE ANALYTICS
RBI Population Health Insights' powerful Predictive Analytics identify risks and predict expenditures over a 12-month time period directly following the current observation period. These analyses allow the user to stratify a particular population by predicted cost and/or hospitalization risk and can be helpful in further sizing programs and understanding the future resource expectations for specific groups
