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The uncertainty and risk created by pandemic-related disruptions in care have health plans in uncharted water when it comes to relying on claims data and utilization patterns to inform their risk models. But while these disruptions weakened the reliability of traditional risk models, they also created opportunities to deepen and enrich member data by leveraging consumer and other data related to social determinants of health (SDoH) that can deliver significant performance and accuracy benefits.
Expanding data sources and enhancing analytics capabilities allows health plans to develop the capacity for more precise, holistic member engagement while improving the most impactful health outcomes in individuals and populations. Doing so will help lift Star Ratings, improve care compliance, close gaps, enhance member satisfaction, reduce costs and drive profitability gains.