Predictive analytics and member targeting reduce ER costs
Avoidable emergency room (ER) visits account for over $38 billion annually in the United States. For years, health plans have employed costly programs across entire populations in an attempt to change member behavior and control soaring costs. Yet the problem persists.
A regional health plan employed Softheon’s proprietary analytics platform and found an efficient, expedient way to identify members likely to utilize the ER inappropriately and prevent avoidable usage through outreach that directed them to alternate sites of care. The results are compelling.