In order to enhance our identification and risk stratification of potential participants, ForeSee utilizes DxCG’s RiskSmart predictive modeling software to identify not only current but projected “at-risk” participants:  those who are the sickest in a given population and who account for the largest proportion of healthcare costs. Use of this software improves our ability to efficiently and effectively match appropriate care interventions to the specific needs of our participants. ForeSee also identifies participants prior to significant claims experience through physician referrals and ER outreach/interactions, as well as through prior authorizations of hospitalizations.

ForeSee’s population-based disease management programs provide care for participants at any point during the chronic condition lifecycle. ForeSee’s predictive modeling software places identified participants into three acuity levels based on the severity of their condition: High Risk, Moderate Risk, and Low Risk. Participants in each acuity level receive interventions appropriate to their condition.