OPSTIFY™ engineered a Value-Based Care Analytics Engine that moves beyond risk identification to prioritize high-opportunity patients, next-best actions, and limited care-management capacity.
Focus Capacity Where Intervention Matters Most
Move From Risk Identification to Earlier Intervention
Connect Intervention to Value-Based Economics
Risk stratification can identify thousands of high- and rising-risk members, but it does not tell a care-management team who should be prioritized today, what intervention is most appropriate, or where limited clinical capacity can create the greatest impact.
Population of 20,000 attributed members,including approximately 3,000 high-risk and 5,000 rising-risk members and a team of only 15 care managers.
Not feasible to investigate every opportunity manually.
The challenge was to transform risk intelligence into prioritized, actionable intervention intelligence.
Focused the POC on a defined Medicare Advantage cohort to identify patients where targeted intervention could address avoidable readmission risk.
Applied focused intelligence to Diabetes and CHF populations, connecting patient risk with relevant clinical conditions and care opportunities.
Mapped prioritized patient opportunities to structured interventions; from specialist follow-up and diabetes education to transportation and other care-management actions.
Enabled care-management leaders to explore prioritization data and investigate patient cohorts conversationally without waiting for new reports or technical queries.
See how care leaders can move from a high-risk population to specific patients, intervention priorities, and actionable next steps through conversational intelligence.
Isolate the patients with the greatest intervention opportunity and deliver structured Next Best Actions care managers can immediately execute.
Automatically prioritize daily patient lists so limited care-management capacity is directed toward patients where intervention has the greatest potential impact.
Identify actionable care opportunities earlier to target interventions designed to reduce avoidable readmissions and unnecessary utilization.
Established the foundation for Patient 360, intervention tracking, outcomes measurement, and ROI intelligence.
OPSTIFY™ moves beyond identifying risk, connecting high-opportunity patients to prioritized interventions, scarce care-management capacity, and measurable outcomes.
Turn risk stratification into prioritized intervention intelligence that helps care teams determine who to act on, where to focus limited capacity, and what action to take next.
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