Clinical analytic healthcare solutions provider Elsevier / MEDai has announced that Lovelace Health Plan in New Mexico has purchased several products in MEDai's suite of Risk Navigator products to drive quality outcomes through predictive analytics. Lovelace will use Risk Navigator Clinical, Risk Navigator Performance and Risk Navigator Financial.
Lovelace reportedly chose the suite of Risk Navigator products because of its ease of use, reliability and transparency of risk predictions, integration of evidence-based medicine guidelines, and the speed and thoroughness of implementation.
Risk Navigator Clinical applies evidence-based clinical rule sets and advanced mathematical process to claims, membership and other data to identify high-risk members. Lovelace will utilise Risk Navigator Clinical to improve its population risk and member disease management. At the population level, Lovelace will better understand what conditions are driving costs within the health plan and what the risk profile is of the population as a whole. At the member level, it will be utilised to show how to manage high-risk conditions (i.e. diabetes, asthma, coronary artery disease, etc.). Clinicians and administrators can then use these clinically based forecasts to allocate resources efficiently and intervene before adverse outcomes occur and unnecessary dollars are spent.
Lovelace will also use Risk Navigator Clinical to improve engagement with clinicians by giving them access to member history and compliance information. Risk Navigator Clinical will allow clinicians to see a member's compliance with evidence-based medicine guidelines.
Risk Navigator Performance provides retrospective and prospective profiling of providers and facilities, and compares provider and facility performance against national and regional benchmarks. Lovelace will use Risk Navigator Performance to view provider profiles internally by focusing on quality and evidence-based medicine guideline compliance rates.
Risk Navigator Financial supports actuarial and underwriting analysis and reporting by leveraging clinical risk information and cost predictions. Risk Navigator Financial will allow Lovelace to better identify and assess the risk associated with an employer group at the time of renewal. Additionally, Lovelace will be able to look at the risk assessment by categories of eligibility for its Medicaid population.
Search for more Analytical Tools
To access our daily STM news feed through your iPhone, iPad, or other smartphones, please visit www.myscoope.com for a mobile friendly reading experience.
