Health Plans

The GeoHealth Platform leverages and trends data on healthcare costs and outcomes, as well as social and environmental determinants of health (SDoH) to identify the growing and changing healthcare needs at the overall population level as well as the community level. For example, tracking population growth in Prince George’s County, MD, left image, along with change in maternal health risk factors, right image allows for all stakeholders, including government, community organizations, health system, and health plans to ensure its capacity and resource levels can continue to meet healthcare needs within those specific service lines.

Our ability to track SDoH factors allows for the creation of a Hierarchy of social determinants in terms of their impact on healthcare costs and outcomes within a specific geography – such as entire regions, or as granular as ZIP Codes or Census Tracts.

The GeoHealth Platform analyzes healthcare cost data against outcomes as well as the social and environmental determinants (SDoH) that influence health outcomes – to identify regions and communities experiencing high healthcare costs (as for the Maryland Eastern Shore, right image) and the SDoH driving that cost (below).

Analysis indicates the high cost ZIP Codes within the region incurs the presence of two specific social determinant factors (left image).

The GeoHealth Platform also identifies the range of cost impact – supporting the creation of an SDoH-based risk adjustment factor allowing health plans to determine member premiums, make coverage determinations, and access the risk of insuring a given patient population.

Following this process has identified SDoH factors that contribute an excess of between $4,000 – $6,500 US Dollars in healthcare costs per patient in a capitation model for an elderly population. Overall for the region, this amounts to potential excess spend of between $12,000,000 and $20,000,000 US Dollars.