Identify Opportunities
to Better Manage
Your Populations

Ingest and enrich your data through our Healthcare Data & Prediction platform to gain access to membership and population data with the Enrollment Analyzer.   

Go beyond just understanding who is enrolled in your plan, dive into which conditions are most prevalent in your population, trends, PMPM spend, high-cost claimant, and quality score data. Plus, evaluate and monitor fee for service and MCO performance. 

Shift to building programs based on who are your most at-risk populations through the enrichment of your data using a library of 1,000+ clinical, financial and behavioral predictive risk scores to identify future risks and clinical and financial opportunities.  

Quickly characterize the health of your population by tracking gaps in care and understanding condition prevalence and the associated costs and trends. 

Aggregate member level opportunities up to the population level using the Opportunity Analyzer and see in dollars the impact of executing different clinical programs based on outcomes or disease state. 

Be confident your clinical program outreach strategies are reaching those members who are most likely to modify their behavior and improve their health using Certilytics’ member-level Target Index. This approach allows you to maximize your outreach and streamline operational and clinical resource efficiency. 

Calculate the total realized cost savings associated with each existing program or strategy with Certilytics Impact Analyzer, an AI-powered program performance evaluation tool.

See in dollars which health and wellness programs are driving value by improving outcomes and lowering costs with analytics that show more than just vendor participation metrics.

Once your programs and strategies are in place, use the Certilytics Impact Analyzer to validate the total realized cost savings and ROI of your total cost of care strategies.

Certilytics proprietary Provider Practice GPT® offers a new approach for evaluating providers by accounting for nuances in patient context to help predict patient pathways and measure provider treatment deviation – which can help identify low quality outlying providers. 

Assess the cost and quality of your providers networks using a provider scorecard with Certilytics’ Network Optimizer and uncover opportunities for reducing expenses and enhancing preventative care strategies to avoid high costs later on.