Bamboo Health Announces Rising Risk, Defining the Next Generation of Care Management with Real-Time Care Intelligence

Bamboo Health, the leader in Real-Time Care Intelligence, announced a new solution, Rising Risk, a real-time risk stratification and patient engagement tool that quickly identifies emerging high-risk patients that may be missed through traditional stratification models. The solution helps organizations identify, analyze and quickly intervene with this cohort to get them the care they need for improved outcomes and cost savings, while delivering personalized experiences that build deep relationships with patients, at scale.

Healthcare is facing an unsustainable crisis in which a small minority of patients drive the bulk of healthcare spend in the US Just five percent of patients account for almost half of the total spend. This cohort includes patients with chronic conditions, often with rapidly escalating care needs and a tendency to land in a high-cost care setting. The members of this group of patients also significantly change year over year, making care management even more complex.

To address this problem, providers and care managers have had to rely on lagged claims data or analyze care teams’ anecdotal notes to try to pinpoint patients who may soon become at risk for health complications or in need of additional care. Oftentimes, if clinical data is used, it does not reach beyond a single health system, adding further complexity and fragmentation to an already inefficient process. Care managers are often at capacity, and patients can slip through the cracks. As a result, patients are not identified as high-risk or high cost until they have already become so, hindering providers’ ability to intervene and coordinate care effectively.

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Advanced workflow analytics extends the power of the Bamboo Health Real-Time Care Intelligence platform within Rising Risk to proactively identify and engage emerging high-risk patients in real time by considering care events as well as social determinants of health to improve patient experience and outcomes.

Rising Risk is built on the Bamboo Health Smart Signals network that supports providers, payers, pharmacies and state governments through its expansive platform present in all 50 states. The network makes Rising Risk unique, allowing it to identify patients with rapidly rising care needs in real time and across state lines.

“Rising Risk helps identify patients most likely to benefit from the intervention of our care management teams, so we can focus our resources on patients that need support,” said Khadija Poitras-Rhea, assistant vice president of population health at UConn Health. “For instance, we had a patient identified by the solution who had not otherwise been on our nurse navigator’s radar but had visited the emergency department (ED) about 20 times in the last two months. We reached out and learned transportation challenges made it difficult to visit his primary care physician. We were able to help him overcome that barrier and not only reduce ED visits, but he feels like he has an ally and better tools to manage his healthcare.”

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Risk Model

Rising Risk equips provider, payer and care management teams with comprehensive and accurate patient identification through robust predictive analytics. The innovative risk scoring model leverages Bamboo Health’s nationwide, real-time ADT (admissions, discharge, and transfer) network for utilization awareness in addition to data that encompasses social determinants of health. With Rising Risk, enterprise customers can:

• Improve speed and accuracy of patient identification with risk scoring model adjustments from user input over time
• Increase care management program enrollment
• Deliver high-quality patient care

Workflow

Rising Risk goes beyond being a patient risk solution, providing workflow features to keep care management teams aligned.

• Identify the key group of patients to focus on for short durations of time
• Set up follow-up reminders to uphold time frames in value-based care contracts
• Enroll patients in care management services
• Add context notes in the patient’s profile for other care team members

Patient Engagement

Using Rising Risk, Bamboo Health customers now can use the solution’s workflow tool to engage patients through its user-friendly interface:

• Engage hard-to-reach patients via in-app workflow tool
• Communicate to the patient via phone and text messaging to coordinate care
• Use a scheduling assistant to quickly and easily book follow-ups

“Waiting months for claims data to assess an ever-changing patient population will not help providers achieve the desired results of value-based care,” said Rob Cohen, CEO of Bamboo Health. “Rising Risk is a game-changer for healthcare, allowing organizations to deliver on the promise of better patient outcomes at a better cost.”

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