Improve premium optimization and member outcomes with next-generation risk management

Approach population risk management more strategically with a Risk Management Program from Discovery Health Partners. With solutions that range from a strategic assessment to a full-scale, enterprise-focused Risk Management Program, you can build a foundation for a consumer-focused, value-based business model that delivers benefits across multiple areas of your organization, including care programs, delivery systems, cost containment, and risk management.  Our Risk Management Program enables health plans to gain better visibility into member health risks, correctly align premium payments with member risk profiles, and develop programs and services that directly reflect their population needs.

Our approach to Risk Management enables health plans to:

  • Understand the impact of provider coding practices on premium payments and improve diagnosis coding accuracy through provider collaboration, outreach, and incentives
  • Improve care management tactics and align products and services with population health needs
  • Understand the health risks of new membership, including those from the Exchange
  • More effectively manage member outreach costs and benefits
  • Design provider networks and provider benefits to incent and reward high-performers
  • Accelerate internal operational efficiency and MLR oversight initiatives

Solutions

  • Risk Maturity Assessment: an objective validation and assessment of the successes, challenges, and opportunities in a health plan’s current risk management capabilities. It results in a roadmap for plans at any level of maturity for an ongoing Risk Management Program at a level of investment and functionality that is appropriate for the health plan and that increases their sophistication year to year.
  • Risk Management Program: a multi-year Risk Management Program based on the outcomes of the Risk Maturity Assessment, may consist of the appropriate combination of four key components: Diagnostic Coding Accuracy and Completeness, Member and Provider Intervention and Retention, Population Health Enablement, and Cross-Departmental Risk Integration.

Delivery

Our Risk Management Program is delivered via our Risk Management Center of Excellence, which combines the expertise of our consulting team with the data, technology, and operational excellence of our broader organization

Learn more

Click here to begin the conversation.

 

 

 

 

 

Discovery Health PartnersRisk Management Program