health cost & risk management llc

Health Cost & Risk Management LLC. (HCRM) provides a wide range of solutions to healthcare organizations worldwide. HCRM provides solutions that focus on addressing some of the healthcare industry's most complex challenges. With our extensive knowledge and capabilities of providing the most accurate predictive modeling and automated claims integration, we provide our clients with actionable information that will enhance revenue and contain cost. HCRM doesn't just look at the highest cost but identifies high risk, future high cost individuals. With predictive modeling our clients have the capability to: Forecast dollars and risk for each individual in the population for the next 12 months Identify a members willingness to maintain or improve health behaviors with a Motivation Score for each individual Forecast emergency room visits and days inpatient for the next 12 months Identify high risk members and rank them by severity and gaps in care Pinpoint risk of non-compliance with national standards of care for 19 chronic conditions HCRM provides clinical predictive modeling services to Third Party Administrators, Brokers/Consultants, Employers, Health Plans, Wellness Vendors, and On-Site Clinics. Predictive modeling enhances our clients ability to focus on the critical clinical issues that are driving cost and accurately identify and stratify key groups within your population providing you opportunity to engage those high risk members. Health Cost & Risk Management solutions include: Claims Data Validation and Normalization Clinical Predictive Modeling Stop-Loss Reporting Custom Database Generation and Reporting Socio-Economic Factors HCRM is now working to supply the industry with socio-economic measures that accurately reflect the risk of members. For the first time, industry players will have the ability to assess the clinical risk of individuals and populations without past claims.