The Effect of Predictive Analytics-Driven Interventions on Healthcare Utilization

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David, Guy
Smith-McLallen, Aaron
Ukert, Benjamin
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Abstract

Among high-risk Medicare Advantage members with congestive heart failure, a proactive outreach program driven by a claims-based predictive algorithm reduced the likelihood of an emergency department (ED) or specialist visit in one year by 20% and 21%, respectively. The average number of visits dropped as well, with a 40% reduction in the volume of ED visits and a 27% reduction in the volume of cardiology visits after the first year.

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2019-04-03
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