Maximize Your Impact on Total Cost of Care

Shift to member-focused programs using Certilytics library of 1,000+ clinical, financial and behavioral predictive risk scores to identify future risks and opportunities at the individual level.

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.

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

Go beyond participation metrics and improve your plan design because you will know exactly which health and wellness programs are driving value – improving outcomes and lowering costs for your members and your organization.

Understand the impact and performance of your strategies compared to the healthcare industry as a whole by using Certilytics’ 3rd party benchmarking data.

Certilytics proprietary Provider Practice GPT® offers a new approach for evaluating providers and building the best networks by accounting for nuances in patient context to help predict patient pathways and measure provider treatment deviation.

Evaluate your network utilizing your data’s provider-level insights in combination with large national data sets to compare how your network is performing.

Plus, maximize the value of your network by integrating Certilytics provider performance solutions into your existing care navigation and decision-making tools.

Identify opportunities to improve your value-based contracting initiatives with local and regional benchmarks to ensure you stay competitive in the market.

Show the value of your existing provider discounts to support ASO sales growth.

Enhance your payment accuracy programs with Certilytics Claim Deep Representation’s GenAI model to accurately identify claims that deviate from expectations while accounting for the nuances of specific provider-patient interactions.

Identify more risks and opportunities with Certilytics’ predictive models, specifically calibrated for Medicare’s senior population.  These insights will give you more confidence in the decisions you are making and the actions you are taking to improve your total cost of care strategies.

With deep expertise in building predictive models, Certilytics can also build customized models tailored to your community’s unique health risks and social determinants of health (SDoH) in as little as two weeks.