PREDICTIVE MODELING

EmmData tools use patient-centric methodologies that describe the effect of the disease on the patient rather than describing the disease itself. We recognize that co-morbidities play a significant role in how a patient is affected. Our process creates actuarial health status cells to which a patient is uniquely assigned. Cost data is subsequently applied. This allows us to model both encounter and paid claims data.



We project the likelihood a patient will be in the top 5% of claimants in the next 12 months. We predict likely future costs expressed as a ratio to the plan average cost. EmmData also provides specialized analyses that focus on risk of high pharmacy cost, future hospitalization, and condition-driven unexpected high costs.