What reports are accessible within the Risk Module of HealthAnalytIQ?

Gain an understanding of what you can review, analyze, and track with the reports in HealthAnalytIQ's Risk Module.

Below is a list of the reports, analyses, and groups that can be tracked using the Risk Module of HealthAnalytIQ. 

1. Utilization Cost – A high-level overview of utilization across the entire organization as it relates to risk, cost, patient encounters, and more. Sophisticated statistical modeling is used to forecast costs across risk categories 12 months into the future before those costs are incurred. Insights into costs associated with members and their families are presented for review and action.
2. High Cost Groups – This high-level dashboard displays a complete list of either individual members or groups within a health plan ranked by their medical loss ratio (MLR). A user can quickly and visually analyze correlations between the MLR, claims paid, premiums received, profit/loss and 12-month predicted costs and overall risk status for each listed member or group. A robust drilldown capability shines more light on the types of claims being paid, where those claims are being incurred, and more, for any time period selected by the user.
3. Probability Profile – A report that profiles the statistical probability of both individuals and groups to experience adverse, cost-related outcomes such as the likelihood to be readmitted to the hospital within 30 days of discharge, likelihood of becoming a persistent user of healthcare resources, probability of being hospitalized due to an injury, probability of ICU hospitalization, and more.
4. Risk Matrix – This Gartner quadrant-style set of analytical dashboards presents correlations between claims and premiums and highlights the interplay between statistical probabilities, risk profiles, claims paid and premiums collected. Statistical probabilities such as Likelihood of Inpatient Hospitalization, Extended Hospital Stay, Unplanned 30-Day Readmission and more, are weighed against claims, premiums, and risk scores of individual members or groups and plotted on the quadrant for visual analysis.
5. Risk Trends – A retrospective “mover” dashboard that tracks members who are trending up or down in terms of risk as well as tracks their historical risk scores, cost, medical conditions, predicted outcomes and more on an ongoing, month by month basis. Changes in health status as well as the development of new medical conditions are highlighted chronologically and graphically along with costs associated with changes in each member’s health status.
6. Risk Spheres – Analyses of stratified patient populations based on the John Hopkins ACG^® risk stratification methodology. Risk Spheres classify patients into HEALTHY, LOW, MODERATE, HIGH, and VERY HIGH risk categories. Risk Spheres™ also present comprehensive patient-specific predictive risk profiles.
7. Provider Profile – A comparison of the risk profiles of provider panels, including weighted risk scores for each provider’s panel, cost analyses, and detailed patient profiles. These detailed provider profiles are presented across multiple disciplines and chronic condition categories.