VitreosHealth is a pioneer of Advanced Population Health analytics leveraging EHR, claims, HRAs and socioeconomic data for predictive risk and prescriptive care management to help:

  • Healthcare systems that offer accountable care with risk-based contracts (ACOs, Medicare Advantage, MSSP, Bundled Payments).
  • Hospital Systems focused on Clinical Integration Initiatives – physician practices and healthcare systems and the demands of coordination of care, particularly for chronic disease patients.
  • Physician Groups with new payment and care models (PCMH, ACOs, both incentive and risk-sharing contracts).
  • Regional Payers (HMOs) who are designing value-based contracts for provider networks and restructuring its operations to minimize Medical Loss ratios.
  • Children’s Hospitals offering specialized care management programs looking for predictive risk models for major pediatric disease conditions – Asthma, Diabetes, Metabolic syndrome and Mental Illness .

We transform healthcare provider and payer economics by helping them proactively manage population risk and lower their operational costs to improve margins.
Healthcare is going through changes at a pace never seen before. The current transformation is driven on keeping the population healthy rather than cure and care for the sick. New models are directed at preventive care, proactive chronic disease care, utilization management, wellness, financial risk taking, incentive management and ultimately accountability by providers and patients for performance.
Population Health is not a new concept. It has been in practice piece-meal predominantly driven by payers over the last 20 years with generally unsatisfactory results as measured in terms of managing the healthcare costs. The primary reason for the disappointing results is the fact that these programs were not built to leverage the trust of the “Physician-Patient” relationship. In most cases these payer-driven programs, consciously avoided the physicians in the payer-driven population health program due to conflictive payment and incentive systems.
The emerging provider-driven, practice-based population health programs opens up a lot of exciting opportunities as they build on the patient-physician relationship and accountability. The changes in the payment systems with the risk shifting to providers and more accountability to patients coupled with the incentives from the pay-for-performance makes the physician-led, provider-driven population health programs very promising in the mission to bend the healthcare cost curve.
Providers are signing on new risk contracts and investing millions of dollars in population health management programs. After a year, most executives are baffled that their population health programs fail to deliver results causing severe strain to the overall strategic health of the organization. There are several reasons for the program(s) failure:

  • To begin with, lack of complete understanding of population State-of-Health (SOH) risk . 
  • Identifying which care management opportunities are the “low hanging” fruits to focus initial efforts based on the organizations existing resources and skill sets .
  • Failing to understand that every year, 15 - 20% patients move from “Hidden” category to “Critical” category (see below diagram) and contribute 40-45% of new costs. Which patients belong to this “Hidden” category and what is driving their risk – disease specific clinical risks or non-clinical risks like socio-economic, compliance, access-to-care, utilization, and perceived well-being

VitreosHealth, a leader in population predictive and prescriptive analytics helps identify the “Hidden” category of population and provides a 360 degree view of the patient as it relates to both clinical and non-clinical risks. Population and patient specific data resides in disparate sources as “dark” data with varying predictive power and execution complexity. VitreosHealth’s 19 disease specific models and patent pending 6 dimensional approach sheds light to data from all multiple sources (Demographics, Claims, EHRs, public, social) to help healthcare organizations design the most effective tailor-made care plans for each patient.

 

VitreosHealth Solutions

Case Study

Alliance Community Hospital case study
Alliance Community Hospital, is an independent 104-bed hospital with an attached 78-bed skilled nursing facility. The hospital strives for clinical transformation, which means creating a care coordinator network for patients experiencing significant social and economic barriers that affect their care,

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