Identifying emerging high risks and costs

D2Explorer stratifies members based on their medical condition, pharmaceutical use, adherence to quality measures, and the quality of care delivered to them. It identifies at a glance those members who are likely to be the most costly next year, thus revealing opportunities for care management.

All members are assigned a Risk Index, based on their diagnoses and health histories. The Stratifier applies hundreds of Quality and Risk Measures to the Risk Index, yielding an Adjusted Risk Index (ARI). For example, members who are not compliant with quality measures are considered riskier, and are assigned a higher ARI.

Derived from evidence-based rules

The Stratifier analytics are based on D2Hawkeye predictive models derived from our Medical Rules Library. Stratification is augmenting by links to cost-based modeling indices.