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Improving member health with predictive risk modeling

Smokers, on average, die 10 years younger than nonsmokers. But that’s just one data point. What happens when you consider all the data that composes the fabric of a member’s health? When you factor in doctor visits, lab results, medication, social determinants, income levels, and more?

Then it becomes a fascinating tapestry of rich data. A very large tapestry of data – that’s impossible to manually process and synthesize.

With so much data, across so many variables, how do you pull the pieces of data together? How do you take the clues left by these health risks and translate them into concrete steps patients can take to improve their health?

Enter, predictive risk modeling.

Predictive risk modeling takes the web of scattered clues, and all that data, and distills it into actionable insights. Intervening with the right members at the right time can help improve members health. Risk scoring helps identify those individuals or populations that pose greatest likelihood for complications and costs.

What is CDPS?

The Chronic Illness and Disability Payment System (CDPS) is a predictive risk model that interprets diagnostic and pharmacy data to assign segments of a population into more than 60 risk categories.

Deploy the Right Care, to the Right Members, at the Right Time

The CDPS predictive risk model incorporates additional risk determinants such as income, social determinants of health and specific assessment scores for more holistic and accurate risk identification. These factors can be individually weighted against population data so care managers can identify individuals at the greatest risk for costs and complications. Those individuals can be targeted for care programs, allowing you to intervene with the right members at the right time.

GuidingCare: CDPS Risk Model (CDPS+Rx)

The CDPS+Rx risk model is fully integrated into GuidingCare and is available exclusively for commercial use within the solution. CDPS+Rx can be used alone or in combination with other risk measures to calculate a risk score representing the risk for future healthcare costs. Learn more here.