ProVentive 2.0’s individual member profiles are designed to help you identify the health care needs of each individual. The individual profile is a comprehensive, multi-dimensional view of a member’s overall health and utilization, including co-occurrence of chronic conditions, related complications, disease progression, behavioral health and psycho-social factors. The profile is developed for each member and includes the following components:

• Disease Modeling – ProVentive 2.0 includes standard disease definitions and progressions which are designed to be customized to your specifications in order to be more relevant to your population and intervention programs. These definitions also recognize the pernicious interaction of physical health, behavioral health, substance abuse and other factors. Paid claims data are primarily used to identify the incidence and relative progression of chronic diseases. ProVentive 2.0’s disease-specific progression algorithms are based on additional clinical factors such as diagnoses, procedures, medications and health care utilization.
• Domain Modeling – Non-medical, psycho-social risk factors impacting health and outcomes such as environment, support, cognition, functional status and financial situation can be incorporated into an individual’s profile.
• Utilization Modeling – Utilization patterns are identified and used to evaluate the relative usage of emergent, inpatient, long term and other health care services.
• Risk Modeling – Using powerful pattern recognition technology, disease, domain and utilization (described above) factors are used to develop individual, customized risk scores. The risk scores are based on the outcomes that your intervention program is trying to avoid (such as hospitalizations, re-admissions, multiple ER visits, nursing home care, etc.).
• Intervention Modeling – Using a combination of clinical rules and pattern recognition technology, the specific clinical points in time where your interventions are the most effective for each individual are identified and integrated with your intervention program.