Stratifying Members As They Arrive Through the Exchanges
In the zero sum ACA marketplace, properly identifying exchange members is critical to plan success and viability. With the right analytics, UPMC Health Plan has outperformed its competition, recording 18 percent higher average risk scores than the rest of the plans in its risk corridor. In this presentation, learn how UPMC was able to create a process to correctly identify, outreach, and engage high risk plan members. Attendees will gain an understanding of the "three R's" of the ACA model, the overall risk challenges of operating an ACA plan, and the UPMC analytics framework for identifying patients in high cost categories. Additionally, they will learn about the underlying UPMC technology enabling their data-driven approach, the results of UPMC's process, and the key takeaways for plans facing similar circumstances.
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Event Type: Webinar
Units Available: 1