Using an ensemble of machine learning models, augmented with clinical expertise, Cogitativo has developed a COVID-19 AI risk scoring engine. The data utilized were the healthcare payors’ historical medical and pharmaceutical claims, along with 300+ peer-reviewed COVID-19 medical literature. These data sets were used to train a series of machine learning models that identify individual members at high risk for adverse outcomes. This capability is currently deployed at two large west coast payors and is immediately available. For one of our clients, we identified over 70,000 individual members at severe risk. With receipt of our insights, one of our clients contacted over 53,000 members within one week.
Our unique data science capabilities, our passion for impact, and our existing data sets enable us to rapidly deploy value- add insights to support our clients in managing their business complexity, in this case, the COVID-19 global pandemic.
Cogitativo has developed and continues to enhance this Payor-oriented scoring system by synthesizing information from hundreds of medical journals and incorporating a retrospective analysis of a client’s members' care journeys related to H1N1. This data set, combined with clients’ historical claim data, allows us to identify members at high risk for adverse COVID-19 outcomes put in the context of the member’s current care journey.
Importantly, the scoring system will continue to evolve as more research data becomes available. We expect that the ranking of some members will change as the scoring system is tuned based on additional data inputs and endpoints information.
Together we can make a positive impact on our healthcare system, our communities, and our loved ones.
Call to action NOW! Our data science insights enable outreach to financially fragile physicians to discuss their capital and on‐going practice needs. Outreach activities should also include supporting telemedicine capabilities and transition to value‐based bundled reimbursement. Together these strengthening activities create a financial ramp for reestablishing face‐to‐face physician‐patient office relationships and to stabilize members access to care
At Cogitativo, we believe that through the combination of advanced analytics, supportive payor organizations, and the willingness of physician practices to change reimbursement schemes, we can create a more resilient, less fragile U.S. health care delivery system. These initiatives will help to mitigate the crisis of reduced access to essential health care services.
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