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Health Cost & Risk Management – Meet A Vendor

Shortlister hosted Rebekah Lane, Head of Sales and Account Management and Bill Bramble, President of Health Cost & Risk Management (HCRM), to share more about driving clinical and financial analytics with artificial intelligence.

PROVIDING PREDICTIVE MODELING TO CHANGE THE FUTURE THROUGH ACTIONABLE INFORMATION

HCRM specializes in collecting and integrating medical data from a wide variety of sources to provide their clients a complete view of plan members’ health status, both now and in the future, by forecasting cost and clinical risk of each individual in the next year. This complete view, looking in the past and into the future, allows clients to identify high risk, future high-cost individuals and groups needing clinical attention, thus providing actionable insights.

Founded in 2004, HCRM provides the predictive modeling and claims analytics platform, Health Risk Monitor, delivering cost-saving visibility and actionable information that help health management vendors, health plans, TPAs, brokers, employers, providers and others reduce the cost and risk of healthcare. The HCRM system predicts the clinical events for each member and attaches a dollar value to those predictions, accurately predicting cost by clinical risk driver plus pharmacy costs, emergency room visits, days inpatient, tracks member compliance with HEDIS guidelines, and much more. Most importantly the system will track all members participating in a care management program to track outcomes.

HEALTH MANAGEMENT STRATEGIES USING CLINICAL PREDICTIVE ANALYTICS

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The HCRM application is a significant driver of better health for its members.  There is a variety of strategies that plans and vendors can use to address those:

 

  • Increase Compliance with Standards of Care for Chronic Conditions: Diabetes, Cardiac, Pulmonary, Depression
  • Focus on “Movers” – Members forecast with increase clinical risk and cost – 20% higher than last year
  • High & Catastrophic Risk Members – Mix of Movers and Multiple/Complex Conditions
  • Pre-emptive Large Case Management – Avoid ER Visits and Inpatient Admits

HCRM’S VALUE PROPOSITION

  • All the data is in-house – no third-party vendors
  • 16 years of experience in collecting, normalizing, and validating the data
  • Data security – SOC2 certified – HIPAA Compliance
  • Transparency in cost
  • The solution can bolt on to any other cost containment program
  • Best accuracy in predicting cost and risk both aggregate and belly button level
  • Dedicated personnel that will provide excellent customer service and responsive to your requests

HCRM PRICING

HCRM provides cost transparency:

  • No implementation fees
  • No minimum number of lives
  • No fees for providing access and training to partners
  • $.75 PEPM

HCRM provides solutions that focus on addressing some of the healthcare industry’s most complex challenges with real time insights through an on-line application, Health Risk Monitor, providing a complete view of your population including employees, spouses, and dependents.

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