CASE STUDY:  Predictive Analytics Improved Risk Adjustment Performance and Generated $23M in Incremental Revenue

Delivering Results That Matter

A regional health plan sought to analyze 343,000 prospective households to expand their acquisition campaign and increase membership. 

The health plan partnered with Welltok’s analytics team to create custom predictive models and identify each individual’s risk of disease by Hierarchical Condition Category (HCC). Upon analyzing the data, Welltok provided an optimized target list that maximized revenue capture results and effectively utilized risk adjustment resources. Since leveraging Welltok's analytics services, they have seen significant results including: 

higher average value per assessment for individuals identified by Welltok as high value compared to original target group
in incremental revenue in the current service year
in Risk Adjustment Factor (RAF) value opportunity was identified across 800 charts