A Better Crystal Ball: Predictive Analytics
for Member Risk

  • April 06, 2021
  • 1:00 PM – 2:00 PM ET
  • Online

Individuals with annual health care costs over $50,000 represent 1.2% of health plan members but drive one-third of plan spending. In the ideal world, health insurance providers could peer into the future and precisely identify which members will become high-cost patients. Armed with this foresight, they would know exactly which interventions could deliver the most impact.

More precise analytics are helping us build a more accurate crystal ball. However, to see clearly what’s ahead, health insurance providers must stratify individuals on multiple dimensions to account for contributing and underlying risk factors. They must also ensure predictions adjust for SDOH-related barriers to health to gain a fairer view of their populations’ overall health needs.

In this webinar, Blue Health Intelligence® (BHI®) will share key factors to consider when developing programs to better predict and target high-risk, high-cost members. BHI’s experts will show how an ensemble of predictive models trained on traditional and non-traditional socioeconomic data can uncover deeper issues impacting individual members. BHI’s medical and product management leaders also will share how analytics that use the nation’s largest commercial claims data set can reveal precise, unexpected predictive insights. Finally, health insurance leaders will learn how new uses of prescriptive analytics can save tremendous time and effort and improve population health through automated, actionable, recommended next steps.

Attendees will learn:

  • How using an ensemble of predictive models avoids the pitfalls of “siloed” analytics and brings forward insights not available to the human eye
  • How health insurance and solutions providers are integrating SDOH- and other non-traditional data to create a clearer picture of member risk
  • How leveraging prescriptive analytics empowers clinical professionals with actionable next steps, giving them a roadmap for improving member outcomes


Russell Robbins, MD, MBA
AVP, Clinical Informatics
Blue Health Intelligence

Dr. Robbins serves as BHI’s AVP, Clinical Informatics. He is an industry leader in creating, measuring, and monitoring clinical programs customized to improve outcomes, lower costs, and improve productivity and quality. Previously, Robbins served as Chief Medical Officer for FAIR Health, the Cambridge Advisory Group, as well as a Medical Director at Mercer, iHealth Technologies, and the clinical leader for large and small companies.

Roxanna Cross
AVP, Product Management
Blue Health Intelligence

Roxanna Cross serves as AVP of Product Management for BHI. She has substantial health care information technology and product management experience applied to the health payer market. With strong competencies in health care analytics, risk management, medical management decision support, and other healthcare products, Cross helps clients bridge business objectives with industry best practices.