Predictive Modeling Used to Recognize Vulnerable Populations; $2-3M YOY Savings Identified

Situation

The AArete team, in collaboration with our client’s team, formulated a methodology to identify initial vulnerable and rising risk populations for Behavioral Health Care Management. We helped the client appropriately manage their Behavioral Health population using analytics to prioritize their care management loads, and staffing analytics to work those loads to improve member outcomes.

Approach

AArete assisted with dataset creation using varied data sources and targeting methodology with scores for impact and engagement. We used a predictive model for rising risk Members and staffing and productivity analytics. This was a development of repeatable processes that can be refreshed periodically.

Results

AArete identified 2% of the total 45K members accounting for 7% of the total spend as of May 31st, 2020. We offered a staff recommendation of 2-3 Nurses and 5-6 licensed Master’s level Clinicians for Behavioral Health Care Management. A total projection of savings of $2.1M to $3.7M year over year was also identified.