We use predictive modeling technology to get ahead of the risk curve and fix the care fragmentation that’s driving employer health care costs
....It's not as complicated as it looks
UpShot Health is guided by achieving defined outcomes for your population, and our technology platform provides the outcome targets to be achieved. We measure everything that happens in your center – and, more importantly, provide our clients and our staff with actionable reporting that details what is happening with community providers.
This is all supported by a robust predictive modeling platform that is able to measure gaps in care, over and under utilization of medical and pharmacy services, identification of employees that are predicted to move from a lower risk category to a higher risk category without intervention, a motivational index that measures your employees' readiness to change unhealthy behaviors, and predicted future and avoidable costs based upon all of these factors and more.
The graph above illustrates patients with gaps in care based on claim files received from health insurance carrier data. The predictive modeling engine is an intelligent learning platform that essentially "connects the dots" to risk stratify your population.
Green vectors represent claim utilization for low risk patients with no gaps in care.
Yellow vectors represent moderate risk patients with one or more gaps in care and the resulting future costs projected to occur without intervention.
Red vectors represent high risk patients with one or more gaps in care and the resulting future costs projected to occur without intervention.
The information is truly actionable and the resulting care encounters enhances the patient, provider, and client experience. We're able to track and measure our performance, and our costs and reporting system are completely transparent. Bottom line — you will always know how your clinic is performing, and together, we will be able to make the necessary adjustments to provide the right care to the right people at the right time.
You're paying for inefficiencies. 1 in 3 healthcare dollars are wasted.
The research indicates that 37% of patients with major chronic conditions are uncoded. To arrive at this result, data was mined from over 4 million active patients with evidence of major chronic diseases. Aggregated data identifies uncoded patients based on clinical evidence such as lab results, provider notes and medications prescribed. UpShot Health's health analytic and predictive modeling platform allows high-risk patients to be found despite the lack of a coded diagnosis on a claim, or an entry on an electronic health record (EHR) problem list. Based on the analysis, 37% of patients with evidence of diabetes, congestive heart failure, coronary artery disease, hypertension, or dyslipidemia are uncoded for one or more of these conditions. Put another way, about 17% of all patients in a typical medical group are uncoded for at least one major chronic condition. For a medical practice of 5,000 patients, this translates to about 850 patients who are uncoded for one or more of these major chronic conditions.
