Predictive Modeling provides a risk assessment and adjustment process that applies available data to identify persons "at risk" for much higher than average future medical service utilization. Predictive modeling can be used for functions including case management, disease management, needs assessment, quality improvement, premium rate setting, and provider reimbursement. Predictive Modeling requires an existing data repository, in which data is mined, and an analytic rules based model is applied from a historical timeframe to predict a future timeframe.
|
