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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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predictive analytics, health care utilization, risk score
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Citation For This Study
David G, Smith-McLallen A, Ukert B. The Effect of Predictive AnalyticsDriven Interventions on Healthcare Utilization. Journal of Health Economics. DOI: https://doi.org/10.1016/j.jhealeco.2019.02.002
Date Posted: 05 June 2019