How Caret Health is Utilizing AI to Engage High-Risk Patients and Improve VBC Outcomes

How Caret Health is Utilizing AI to Engage High-Risk Patients and Improve VBC Outcomes

Results Show Drastic Improvements in Cost, Quality, & ROI!

Leading the Way

In the past few years, it seems Artificial Intelligence (AI) as been infiltrating just about everything we know and love yet the advancements of Ai in healthcare still seem lackluster.

Recognizing this opportunity, Caret Health is pioneering a revolutionary approach by employing advanced technologies that include AI and predictive analytics to redefine how these high-risk patients are engaged and managed. Navigating the complexities of Value-Based Care (VBC) requires innovative solutions, especially when faced with the daunting task of managing high-risk patient populations who are often at the focal point of healthcare resource utilization.

Targeting Populations & Defining High-Risk

High-risk patients are often the largest consumers of health resources, making up over 50% of annual healthcare costs.
<1% of current solutions are tailoring solutions to address this.

Many high-risk patients are burdened with multiple chronic conditions. By strategically targeting focused support interventions among these groups, and using a hands-on centralized team to do the work without draining their customer's resources, Caret Health ensures high-impact results with greater returns on outcomes and ROI.

Caret Health first honed its proprietary, intelligence driven, patient engagement strategies by working with Medicare Advantage (MA) populations. The choice to start with this group initially stemmed from strategic opportunities to refine methods with chronically ill, high-risk patients, age 65+, a demographic known for its complex healthcare needs. After achieving significant success in increasing engagement (pictured below) and improving outcomes, the company expanded their model.

Recognizing there are no 'one-size-fits-all' approaches to healthcare...

The Caret team developed an adaptable and scalable approach that deploys strategically targeted interventions to drive results while minimizing cost and productivity burdens. Using Ai and predictive technologies, Caret can algorithmically help customers assess which high-risk, high-cost target population will yield the greatest return.

The flexibility of their approach combined with the continuous growth of their proprietary intelligence algorithms (through learned intelligence) ensures Caret can customize a program for just about any client. You will find some example of the targeted populations Caret has previously worked with in the image below...

Using AI to Enhance Patient Engagement & Outcomes:

Caret believes in taking a hands-on approach to helping their customers achieve results such as care gap closures but at the core of Caret Health’s strategy is the intelligent utilization of AI to identify and engage high-risk patients before their conditions escalate thus smoothing care pathways while reducing unnecessary hospitalizations and ER visits.

Remote monitoring and patient engagement interactions are continuously examined by algorithms designed to improve and customize care. A centralized care team (initially provided by Caret) uses these findings to anticipate patient needs and intervene preemptively. The algorithms can even recommend specific agents work with patients based on things like cultural and linguistic needs. This ensures every patient who enrolls in the program receives care that is not just timely but aligned with their individualized needs.

Additional algorithms designed to identify disparities and flag possible social determinant of health (SDoH) issues enable Caret Health to bridge care gaps often exacerbated by socio-economic barriers. While Caret aims to help customers achieve results that drive fiscal success, their holistic emphasis on personalized care paths underscores their deeply rooted passion and commitment for enhancing patient quality of life.

Using AI to Improve Quality Ratings and Enhance VBC Financial Sustainability

With the ability to predict and optimize each actions impact Caret’s system can prioritize clinical tasking and care coordination to ensure outcomes. The integrated dashboard and monthly report updates help customers visualize this progress by sharing insights on key processes such as screening, clinical pathways, tasking & case management, patient engagement, and staff utilization.

Results in the images below demonstrate Caret's work with an independent practice association within the Inland Empire region of California. The target demographic was 5000 patient lives, a large portion of which were high risk patients with multiple chronic diseases. Caret was successful in helping this client boost value-based performance, lower total cost of care, and capture additional revenue.

Results from Caret Health's Inland Empire Case Study

Conclusion: Caret is Bringing AI Innovation to Healthcare and Outcomes Are Improving!

The integration of AI in managing high-risk patients is not just a technological advancement; it is a paradigm shift in how care is delivered in a value-based framework. Caret Health is at the forefront of this shift, demonstrating that effective patient engagement driven by AI not only fulfills the clinical objectives of VBC but also enhances its financial viability. As healthcare continues to evolve towards value-based models, the role of AI in patient care is set to become increasingly fundamental, marking a new era of efficient and effective healthcare delivery.

The impressive outcomes demonstrated show Caret’s effective blend of cutting-edge technology and a deep commitment to patient care. Their approach underscores our commitment to enhancing patient engagement through personalized communication strategies and continuous engagement tactics, leveraging AI to bridge gaps in healthcare accessibility and compliance while simultaneously driving quality, cost, and ROI improvements customized to each customer’s goals.

Caret Health's commitment to transforming healthcare delivery underscores its role as a catalyst for change in addressing the complex healthcare needs of underserved communities. Caret aims to improve quality, cost, and ROI.

Looking to discuss partnerships, pilots, or just learn more? Caret's Sales Leadership team would be happy to assist you.

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