Member management practices are strongly related to quality of care and productivity outcomes. Improved patient management practices throughout the care continuum are associated with significantly lower mortality rates, lower unnecessary hospital readmissions and better financial performance. The problem is that there are significant variations in the quality of patient management throughout provider networks. Employing PointRight predictive analytics helps to level the playing field and give you more insights into how providers in your networks handle member management and how they can continually improve the process.
PointRight predictive analytics delivered through our RADAR service provides deep insight into key member management data, including Activities of Daily Living (ADLs), cognition, depression, pain, falls, mortality, hospital admissions, pressure ulcers and community placement. PointRight conducted a study in Florida of 3,667 Medicaid long-term care members residing in 80 facilities. It was found that 93% of members who were receiving active discharge planning had a greater than 15% risk of return to the Skilled Nursing Facility (SNF). Using PointRight analytics, you can gain a thorough understanding of specific readmission risk factors for improved and efficient member care plan development.