Putting THE pieces togetherIt’s hard for health plans to do a great job when they are missing up to half of the information.

Research has shown that social determinants play a significant role in how members utilize health care resources and on likely outcomes. Yet, many health plans lack this crucial data.

Group and member churn creates an ever bigger data void, and health plans often have very little information (data) about a significant portion of their membership. This combined data gap limits the predictive power of any analytic tools, and fast growing health plans are even more at risk of making decisions guided by only half the facts.

Innovative predictive products like Optum® Symmetry® Pharmacy Risk Groups (PRG) can help put the missing data pieces together. Traditional predictive modeling tools need 12 months of data, while PRG requires only a few months of data to develop a relatively accurate picture for most members. Combined with additional social determinants data, PRG can augment already completed data and provide health plans with a deep understanding of their membership.

THE RESULTS

• Faster engagement and knowledge of new members

• Deeper knowledge of existing members

• Improved outcomes for your members and groups

• More accurate renewals and shared savings projections

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Stress

Education

Neighborhood

Social cohesion

Employment

Access to health care

Transportation

Access to healthy food

Housing stability

Literacy

40% of their membership.

Health plans have INCOMPLETE INFORMATION on as much as

SOCIAL DETERMINANTS

that complete the puzzle