Abstract: An enhanced risk management method is provided in which a diverse set of inputs, such as demographic variables, risk adjustment factors (RAF) of previous years, and claims of previous years, are used in the training of a prediction model configured to predict both a standard RAF based on the assumption that a healthcare system in question continues its current, possibly suboptimal, operations, and an improved RAF based on an idealized workflow in which all of a member's Hierarchical Condition Category (HCC) codes are captured appropriately at the earliest time possible.

Abstract: Various areas of medicine and healthcare may benefit from improvements in the identification of and mitigation of health risks. For example, medicine and healthcare may benefit from systems and methods that can mine literature to select and analyze the risk factor(s) contributing to the development, progression and management of common health conditions. A method can include receiving an input health condition. The method can also include scoring the health condition based on a plurality of risk factor sources to generate a health score. The method can further include providing the health score and at least one remediation goal based on the risk factor sources.

Abstract: Certain embodiments of the present invention relate generally to using machine learning or other automated techniques to among other things, identify, estimate, and/or predict patient health conditions. Furthermore, certain embodiments of the present invention are related to health interventions performed to reduce the risk of developing diseases and health conditions. This risk reduction improves the overall health of the individual and/or the population and helps reduce healthcare costs.

Abstract: Various areas of medicine and healthcare may benefit from improvements in the identification of and mitigation of health risks. For example, medicine and healthcare may benefit from systems and methods that can mine literature to select and analyze the risk factor(s) contributing to the development, progression and management of common health conditions. A method can include receiving an input health condition. The method can also include scoring the health condition based on a plurality of risk factor sources to generate a health score. The method can further include providing the health score and at least one remediation goal based on the risk factor sources.