Predictive Models for Integrated Care Engagement and Management

Value-based reimbursement through integrated models of care requires robust data management and the sophistication of predictive analytics to best determine strategic management of high-risk, high-cost populations. We will discuss machine learning predictive models that identify population members most likely to benefit from integrated models of care and provide methods for engaging them. We will then discuss using claims data to develop predictive machine learning models that strategically direct clinical interventions by quantifying population member risk of hospital admissions and readmissions as well as high cost during future time intervals. Optimization of clinician focus will be emphasized.