CORE Pathways

CORE Pathways: The clinical episode grouper for the age of AI

When we started Certilytics, we faced a choice: Purchase a legacy clinical episode grouper or build our own. We knew from experience that many of the standard groupers relied on outdated methodologies, some of which have barely been updated since the 1990s.

So we launched CORE Pathways—a clinical episode grouper built for the age of AI. CORE now serves as the backbone of our predictive analytics and has bested some of the most widely used legacy groupers in head-to-head comparisons performed by our customers.

CORE Pathways Supports:

• Enterprise Reporting. Identify, report, and benchmark cost trends, provider treatment patterns, condition severity, and health outcomes across billions of member records
• Cost & Utilization Analysis. Standardize and aggregate raw claims data to perform analysis at the member level, enabling advanced predictive analytics of complete episodes of care, utilization patterns, emerging disease onset, gaps in care, and a member’s likelihood of engagement
• Provider Profiling. Develop high-performance provider networks supporting fee-for-service and value-based arrangements, and measure financial performance and adherence to quality standards
• Care and Disease Management Strategies. Evaluate care pathways and costs for a given condition
• Clinical Outcome Measurement. Review performance, perform risk assessments, and analyze spend, helping business and clinical leaders make more informed decisions
• Quality Reporting. Measure performance based on quality standards and benchmarks

Ready to learn more about CORE?

Read the CORE Pathways Brochure!