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Health plan
Member Risk Stratification Agent
Scores every member for admission and utilization risk using claims and clinical history, refreshed as new data lands.
<div class="hx-demo-box" style="margin-top:40px;border:1px solid #D2D2CA;border-radius:12px;overflow:hidden;background:#fff;box-shadow:0 12px 32px -12px rgba(23,25,21,.18)"><div style="background:#F7F7F3;border-bottom:1px solid #D2D2CA;padding:10px 20px;display:flex;align-items:center;gap:10px"><span style="width:11px;height:11px;border-radius:50%;background:#E4E4DE"></span><span style="width:11px;height:11px;border-radius:50%;background:#E4E4DE"></span><span style="width:11px;height:11px;border-radius:50%;background:#E4E4DE"></span><span style="font-size:12px;color:#8B9086;margin-left:6px">payerops.local/risk/panel-view</span></div><div style="padding:22px 22px 6px"><div style="font-size:11px;letter-spacing:0.06em;text-transform:uppercase;color:#585D54;margin-bottom:14px;font-weight:600">Panel distribution by risk tier</div><div style="display:flex;align-items:flex-end;gap:18px;height:120px"><div style="flex:1;display:flex;flex-direction:column;align-items:center;gap:8px;justify-content:flex-end;height:100%"><div style="width:100%;background:#D2D2CA;border-radius:6px 6px 0 0;height:74%;animation:fadeUp .3s ease both"></div><span style="font-size:12px;color:#585D54">Low · 64%</span></div><sc-if value="{{ r2 }}"><div style="flex:1;display:flex;flex-direction:column;align-items:center;gap:8px;justify-content:flex-end;height:100%"><div style="width:100%;background:#E8D889;border-radius:6px 6px 0 0;height:44%;animation:fadeUp .3s ease both"></div><span style="font-size:12px;color:#585D54">Moderate · 22%</span></div></sc-if><sc-if value="{{ r3 }}"><div style="flex:1;display:flex;flex-direction:column;align-items:center;gap:8px;justify-content:flex-end;height:100%"><div style="width:100%;background:#E0554F;border-radius:6px 6px 0 0;height:24%;animation:fadeUp .3s ease both"></div><span style="font-size:12px;color:#8A2E29;font-weight:600">High · 14%</span></div></sc-if></div></div><sc-if value="{{ isDone }}"><div style="margin:16px 22px 20px;padding:14px 16px;border-radius:8px;background:#FCEFED;font-size:13px;color:#8A2E29;animation:pop .4s ease both">Member #70144: 3+ chronic conditions, 2 ED visits in 90 days, risk score 82. Routed to care management worklist.</div></sc-if></div>
window.HX_DEMOS=window.HX_DEMOS||{};
window.HX_DEMOS["mrs"]=function(Base){
const CYCLE_SEC=8;
class Comp_mrs extends Base {
state={t:0,name:'',email:'',org:'',formSubmitted:false};
componentDidMount(){
this._start=Date.now();
this._iv=setInterval(()=>{
if((Date.now()-this._start)/1000>=CYCLE_SEC){clearInterval(this._iv);return;}
const t=((Date.now()-this._start)/1000)%CYCLE_SEC;
this.setState({t});
},150);
}
componentWillUnmount(){clearInterval(this._iv);}
onName=(e)=>this.setState({name:e.currentTarget.value});
onEmail=(e)=>this.setState({email:e.currentTarget.value});
onOrg=(e)=>this.setState({org:e.currentTarget.value});
submit=()=>this.setState({formSubmitted:true});
renderVals(){
const t=this.state.t;
return {r2:t>=0.8,r3:t>=1.8,isDone:t>=3,
name:this.state.name,onName:this.onName,email:this.state.email,onEmail:this.onEmail,org:this.state.org,onOrg:this.onOrg,submit:this.submit,
formOpen:!this.state.formSubmitted,formSubmitted:this.state.formSubmitted,nameSuffix:this.state.name?', '+this.state.name.split(' ')[0]:''};
}
}
return Comp_mrs;
};
Score your own membership →
Free to start. No credit card.
How the Member Risk Stratification Agent works
1
Ingests claims and clinical history
Ingests claims and clinical history
Pulls the member's claims history and available clinical data.
2
Scores admission risk
Scores admission risk
Applies a risk model to estimate the likelihood of hospitalization or high utilization.
3
Segments the population
Segments the population
Groups members into risk tiers for care management targeting.
4
Step label
Refreshes on new data
Recalculates scores as new claims and encounters post.
5
Step label
<1 sec
to score a member on new claims data
Daily
refresh as claims and encounters post
3 tiers
segmented for care management targeting
Target the members who actually need outreach.
Start free, we'll score a sample of your real membership so you can see the tiers.
✓
Scored against your actual claims and Rx data
✓
Feeds directly into your care management worklist
✓
Free to score your first 1,000 members
Starts free
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