Proactive Patient Management

Health risks and care options are essentially unlimited, but the resources available for interventions are often fixed. ARTO™ gives payers and providers the ability to optimize the allocation of fixed resources by identifying patients most at risk of costly health events and most likely to benefit from specific interventions. Data-driven decisions about which patients require extra attention lead to better outcomes for patients and lower costs for providers. ARTO™ is able to balance potential benefits with limited resources for at-risk organizations.

Focus on High-Utilizing Subpopulations

Healthcare spending is highly concentrated: a recent IMS Health Report (focused on the US commercial market) found that 1% of the population accounted for 25% of spending and 15% of the population accounted for 74%.¹ CliniCast can help case managers work smarter by identifying patients in the top 20% of cost and recommending individualized interventions to help manage their risk.

Patients in this Top 15% risk tier frequently suffer from at least one major chronic disease (such as heart failure, diabetes, asthma, COPD or ischemic heart disease) and have a previous history of higher-than-expected utilization (such as multiple inpatient admissions in the last six months). Predicting outcomes and costs in this high risk group defies simple methods.

CliniCast uses very sophisticated risk algorithms to predict outcomes and costs for patients in the Top 15%. By building risk models that are accurate to the subpopulation level (for example, patients with heart failure; patients with recent discharge), we can better predict outcomes and costs, empowering providers to better allocate resources.