Risk Optimization
Providers – Get ready for the next phase of Value Based Care
The Challenge of Risk Bearing Organizations
Risk Bearing Healthcare Providers have a very complex challenge of balancing cost versus quality of care. Leaders of Risk Bearing Organizations must constantly keep an eye on quality of care while managing cost. With today’s revenue cycle and capitation management systems, providers can run day-to-day operations; however, visibility, reporting and optimization are a growing challenge.
While Risk Bearing Healthcare Providers have access to all of the data, they are not able to effectively use the data to improve margins and care quality.
Bloom Solution
Risk Optimization Engine
Our Risk Optimization Engine brings together cost data, quality data, capitation data and EMR data into a common coordinate system.
Bloom's Analytics and AI Models process this integrated data to help drive value for risk bearing organizations
Solution Value
Reduce medical loss ration by advanced benchmarking and provider engagement
Reduce administrative costs by automating utilization and cost management tasks
Improve compliance through automated reporting
Improve patient outcomes through proactive engagement
Improve patient and provider satisfaction
Bloom Value’s Risk Optimization Engine combines your data with external data to answer these questions. Just AskBloom!
CFO
- What is going to be my margin and financial picture this year?
- Which providers are driving utilization outside norms after accounting for disease burden?
Compliance Director
- What is the Credentialing Status of my provider population?
- How can I keep on top of my reporting requirements to payors and regulators?
Quality Director
- What are my quality targets and how do I achieve them?
- Where are my HCC gaps and what actions do I need to take to address them?
Utilization Director
- How can I avoid missing Auth SLA deadlines without scrambling at the last minute?
- How can we scrutinize fewer auths?
CMO
- Which providers are over-referring?
- How can we improve member outcomes while reducing costs?
Request A Demo
Find out how your organization can realize value in just six weeks and three clicks.
