Disease Management & Predictive Modeling

Predictive Modeling, Comprehensive Chronic Disease Management and Provider Profiling and Intervention Services


Roughly 80% of all healthcare costs are generated in the care of roughly 20% of the employee population. The best way to contain rising healthcare costs is to improve the outcomes experienced by the 20% who drive those costs. Improving customer quality of life is also the ethically right thing to do, and is the most enduring healthcare service anyone can provide.

Healthx works in concert with American Health Data Institute (AHDI) to offer Population Health Enhancement, a service that combines Predictive Modeling, Comprehensive Chronic Disease Management, and Provider Profiling and Intervention services. The Healthx Population Health Enhancement process results in an average savings of 5% of total plan claims expense. When used with the PHE Endorsed Provider Programs, PHE results in an average savings of up to 10% of total claims expense.

The Population Health Enhancement (PHE) process focuses on:

  • Actionable data that aligns information and incentives
  • Broad management of 19 conditions plus co-morbidities
  • Higher participation through opt-out model

PHE includes the following comprehensive employee and provider solutions:


Actionable Employer Reporting Programs

  • Reports on the Health Index of an employee population
  • Tells employers why their costs may be out of line (demographics, illness burden, unit price, utilization, etc.)
  • Helps employers align their plans to reduce overall claim costs
  • Identifies employees needing chronic disease management

Targeted Employee Intervention and Support Initiatives

  • Nurse navigator Coaching to Chronically Ill (Outbound)
  • Proactive maintenance Care Review and Appointment Setting
  • 19 Chronic diseases monitored and managed
  • Utilization of Advanced Predictive Modeling
  • Identification of high quality, cost effective providers
  • Steerage to high quality, cost effective providers

Targeted Provider Intervention and Support Initiatives

  • Nurse navigator-Maintenance care review and appointment setting
  • Stepped Down Utilization Management
  • IView™ - Practice pattern deviation and cost review tool available for providers.