CASE STUDY September 17, 2023

Preventing Potentially Avoidable Risk Events in Healthcare


Business Objective

Our client, a major provider of health insurance plans in the US, wanted to prevent avoidable hospitalizations as they carry a significant clinical and economic burden. Early intervention and effective primary care through predictive analytics assist in driving better care and disease management programs, thus preventing hospitalizations. More specifically, the client wanted to:

  • Drive improvements in the existing set of ROX (risk of event) models — Risk of hospitalization and ER visits in the next 6 months, and risk of high-cost claims in the next 12 months


  • Retaining model interpretability while improving performance
  • Extracting time related features for critical data elements like diagnoses and procedures
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