Helping one health plan accurately identify and review their most high-cost, complex cases

Like many organizations, Geisinger Health Plan recognized most of their costs were driven by the small group of members with the most complex conditions. On average, high-cost claimants make up 1.2% of the population and are responsible for 31% of all medical costs. In addition to curbing costs, Geisinger Health Plan wanted to improve its ability to accurately identify high-cost and complex cases, and ensure its members get the right care with the best possible outcomes.