IDENTIFYING PROGRAM MEMBER DATA RECORDS FOR TARGETED OPERATIONS

    公开(公告)号:US20190156955A1

    公开(公告)日:2019-05-23

    申请号:US16255727

    申请日:2019-01-23

    Abstract: A system comprising a computer-readable storage medium storing at least one program and a method for identifying care management program members to target for therapeutic intervention are presented. In example embodiments, the method includes identifying a set of candidate member data records from a plurality of member data records, and using data models to determine a risk score, a benefit score, and a participation score associated with each candidate member data record. The benefit score provides a measure of a propensity of the corresponding member to benefit from the therapeutic intervention program, and the participation score provides a measure of a propensity of the corresponding member to participate in the therapeutic intervention program. The method further includes identifying target members for the therapeutic intervention program from the set of candidate member data records based on respective benefit scores and participation scores.

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