More than just an analytics tool
Optum® Risk Analytics is more than an analytics tool. It’s a comprehensive risk adjustment analytics platform that turns data into actionable insights at the touch of a button.
It is an essential tool for health plans and provider organizations. With Risk Analytics, your organization can launch and track campaigns to close risk score gaps and improve quality of care — all within a single application.
Risk adjustment suspecting
Leverage risk adjustment suspecting and gap analytics based on historical data with simple workflows to manage prospective, concurrent and retrospective campaigns.
Member and provider stratification
Stratify members and providers by numerous data points and attributes — including risk scores, disease gaps, prevalence, eligibility, provider types and more — for direct, targeted impact at campaign or program levels.
Chase lists
Generate chase lists by prioritizing high-risk members for more immediate care.
Streamlined UI
Customize your member- and provider-level reports and easily view campaign performance metrics — such as total eligible members and top 5 suspected and captured hierarchical condition categories (HCCs) — with our intuitive UI.
SDOH analysis
Create member cohorts based on social determinants of health (SDOH) factors, including age, gender, zip code, race and ethnicity. Leverage this analysis to identify which member segments need additional care or services.
Key benefits
Real-time data insights
Make sense of your data with Risk Analytics. Our analytics platform can ingest large volumes of patient data and extract key trends, such as top suspected diseases, average risk score and provider recapture rates.
Comprehensive reporting
Gain access to a full suite of reporting that can be customized based on numerous filters.
Earlier interventions
Our tool can highlight gaps in care, such as members with no provider visits and members with no annual wellness visits. This enables you to implement targeted care management strategies for these patients.
Improved quality of care
Risk Analytics can ingest large volumes of patient data to identify and quantify the underlying health risks of each patient. Leverage this information to develop targeted and timely care plans.
Risk Analytics can help you plan ahead
Impact analysis: Our analytics technology ingests your member data to estimate the potential decrease in risk scores for your risk adjustment program.
Member risk assessments: We’ll provide you with a more accurate risk assessment of your member population based on the changes to unique HCCs and HCC mapping.
Strategic recommendations: Our experts will share strategies for counteracting a decline in risk scores, such as developing prospective care programs and improving member engagement.
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