ISCEBS 2022: 3 Healthcare Predictive Analytics Takeaways

08/11/2022 News

Innovative Ways Employers are Addressing High-Cost Claims

We were thrilled to be a part of the ISCEBS conference this year in Toronto! Thank you to all those who connected with us.

The conference featured the presentation “High-Cost Claimants: Drivers and Emerging Trends” led by Wes Smith, Certilytics’ Senior Vice President for Advisory & Consulting.

Here are three highlights from Wes’ presentation and the conference:

1. More Employers are Looking for Proactive Strategies to Address High-Cost Claimants

The number of high-cost claims is rising, and benefit professionals are looking for innovative ways to address the underlying issues driving these catastrophic claims.

In his presentation, Wes noted that high-cost claimants make up just over 1 percent of members, but account for over a third of cost. Over half of these members have chronic conditions, and 47 percent have acute conditions.

More employers and benefit professionals are leveraging predictive modeling to enact more personalized and preventative care, as well as control specialty pharmacy spending. This enables them to take action to avoid or mitigate high-cost events before they occur.

The Result: improved employee well-being and reduced costs.


2. There’s a strong business case for addressing health equity

The case for addressing health equity isn’t just moral—there’s also a strong business case for reducing social barriers to care.

Social barriers cause patients to miss out on preventive care, leading to high cost events that could have been avoided.

Social Determinants of Health (SDoH) factors can also increase absenteeism, lead to more emergency department visits, and can cause lower productivity—an enormous cost for Plan Sponsors that could be mitigated through proactive outreach.

Learn more about how Certilytics predicts SDoH risk, and how we can help you address health equity challenges in your population.


3. Meeting the “New Normal” with Connected Healthcare Data

A big topic at the conference was how to respond to the “new normal” working environment brought about by the COVID-19 pandemic. Changes in employee mental health expectations, keeping and retaining top talent, and allocating resources toward more wellness initiatives were all top of mind.

As several speakers mentioned, robust analytic tools capable of connecting the vast array of data sources from both inside and outside the clinician’s office – especially social determinants of health factors – is critical to these efforts.

It’s why more healthcare organizations are turning to data management tools that produce holistic, forward-looking views of member and patient health—with AI-powered enrichments that enable advanced predictive analytics.

Not only that, but healthcare organizations are increasingly demanding customizable tools that meet their specific clinical and business needs, allowing them to build their own reports and visualizations and answer their most pressing analytic questions.


Thanks again to all those who made time to connect with us in Toronto—we hope to see you again (or for the first time) at next year’s conference!

To learn more about how Certilytics can help you advance your health equity goals, data connectedness, and improve your high-cost claimant spending, contact us for a product demonstration or to meet with our team of experts.