Case Study: California-Based Health Company improves high-risk patient prediction with Clarify Health

ACO Success Through Better Performance and Operational Intelligence

California-Based Health Company, a large multi-specialty physician group in Southern California, needed a more accurate way to identify high-risk patients for palliative care and other care management programs. Using Clarify Health’s Clarify Risk / Member Risk solution, the organization aimed to predict future utilization and outcomes earlier than its existing clinical protocols could.

Clarify Health implemented prospective predictive models using claims, clinical, geographic, and social behavioral data to identify patients with the greatest need for high-touch care. The results included more than $5K in savings PMPY for the high-risk pool, a 34% improvement in mortality prediction accuracy versus Elixhauser, and 2-3x better care manager productivity, while also helping identify palliative care patients about 4 months earlier on average.