Forecast Health Analytics Help Health Systems and ACOs Maximize Bundled Payments Profitability

DURHAM, N.C., April 12, 2016 /PRNewswire/ -- Forecast Health, an innovator in predictive analytics that improve patient and population health, today announced a solution to help health systems and ACOs manage risk and improve the profitability of bundled payments.  Drawing on patient-level social determinants of health (SDH) data, Forecast helps organizations identify high-cost patients and predict risk -- critical factors in determining whether the costs of care will exceed the bundled payment.

"We combine clinical, claims, and SDH information to identify, prioritize, and dramatically reduce risk in bundled payment programs," said Michael Cousins, PhD, Forecast's President and Chief Analytics Officer.  "While other companies use SDH data at the ZIP-code or block level – if at all – our ability to use patient-level information is transformative for organizations trying to improve clinical and financial outcomes."

Under the Center for Medicare and Medicaid Services (CMS) bundled payment model, providers receive a single payment for all costs associated with an episode of care.  With bundled payments, provider organizations assume significant financial risk: If a patient has complications, must be readmitted, or is discharged to a needlessly expensive rehab setting, costs for the episode can quickly exceed the bundled payment.  CMS now requires bundled payments for joint replacement in 67 MSAs, covering approximately 800 hospitals. 

Forecast Health uses SDH, claims, and clinical data where available to help health systems and ACOs predict which patients are likely to experience costly adverse events, and provides care teams with patient-specific guidance on how to reduce that risk. Forecast also provides guidance on which discharge setting – either a skilled nursing facility or home – will yield the best outcome at the lowest possible cost.

"With CMS' bundled payment for joint replacement mandate, the future of value-based medicine is now," said Cousins.  "Organizations that use data to improve care, reduce costs, and carefully manage risk are the ones that will be profitable and thrive."

About Forecast Health

Forecast Health's next generation analytics help healthcare organizations improve patient and population health by identifying "impactable" patients who are at high risk of adverse events, and providing patient-specific guidance to mitigate that risk. To learn more, visit forecasthealth.com and follow us on Twitter or LinkedIn.

SOURCE Forecast Health

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