Risk Identification

Overview Facts

  • Is Your Health Plan Identifying and Managing Risk? 
    • Do you know the true prevalence of chronic conditions and care gaps?
    • Have you got a handle on exactly what is driving your present and future costs?
    • MCM’s Risk Solutions provide the first steps to effective plan risk management.
  • MEDai Predictive Modeling of Medical & Rx Claims
    • Initial 24 month retrospective analysis to establish disease prevalence, gaps in care, plan cost drivers and forecasted risk.
    • Ongoing monthly analysis of all medical and Rx claim data
    • Web Based data access for our payer partners
    • All analyses conducted by Registered Nurses and Physicians
  • Personal Health Risk Assessments
    • Web-Based with instant member feedback
    • Educational links targeted to member risk
    • Registered Nurse review of results and member engagement
    • Plan summary report on preventable risk helps focus interventions and education
  • Onsite Biometric Screening
    • Finger stick or venipuncture options
    • Testing for key risk factors
    • Onsite member results
    • Immediate member engagement

Program Impact

  • Identify Plan Health and Cost Risks.
  • Focus Education and Engagement of At-risk Members.
  • Identify At-risk Members Flying Under the “Claim” Radar.
  • Increased Identification of Potential High Dollar Claims