| 摘要 |
The present percolator systems and methods identify and coordinate outreach for members who are potentially at risk, based in part on contract requirements, automatically-assigned risk levels, or gaps in the members' healthcare, including gaps related to social considerations and workflow. Exemplary embodiments of the systems and methods may utilize business rules combined into triggers, with each trigger being assigned a weight. Each member may be assigned an outreach score by combining the weights of triggers applicable to that member. Members may then be assigned to a risk level, or acuity level, and prioritized for outreach according to their outreach scores. The risk level assignments may drive the type of staff and the type (i.e., personal, telephonic, mail, etc.) and frequency of outreach interactions. Other embodiments of the percolator systems and methods are also disclosed herein.
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