Predictive modeling plus intensive case management deliver solid results for Medicaid plan.
That's what happened to AmeriHealth Mercy, a Medicaid health plan based in Harrisburg, PA. And it resulted in skyrocketing costs and runaway utilization. However, the health plan devised a comprehensive approach to managing the population that has worked so well that developers are now interested in sharing the approach with other Medicaid health plans.
D019090:Case Management; D003953:Diagnosis-Related Groups; D005544:Forecasting; D006801:Humans; D007343:Insurance Carriers; D008484:Medicaid; D010414:Pennsylvania; D020379:Risk Adjustment / Q000379:methods*