RiskSmart

Whether your organization has a population of 5,000 or 50 million, RiskSmart™ makes it possible for you to harness the power of your health care data.

Running as a single application, RiskSmart conveniently allows you to input enrollment, pharmacy, and diagnosis data, while offering the option to apply the right model for your business purpose. The software includes pharmacy and/or diagnosis models that can be easily integrated into your existing databases or data warehouses.

RiskSmart makes it easy to:

• Identify high cost cases for care/disease management intervention.
• Compare providers (or health plans) fairly, adjusting for differences in health status.
• Make predictions of resource use for individuals and populations.
• Establish health-based and performance-based payments.
• Negotiate payments and incentives.

The Right Model for the Right Purpose

One predictive model does not fit all business needs or datasets. That's why RiskSmart offers more than 30 variations of the DCG and RxGroups® models to cover a wide range of business purposes, including, high cost case identification, underwriting and predicting the likelihood of a hospitalization.

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