Jmh Predictive Model

JMH follows different predictive models in order to enhance customer experience, and to increase customer referral as well. I will address 2 examples on how JMH uses predictive models.
JMH created a predictive model based on member’s use of the ER (Emergency Room) services, it has been identified that if a patient has a constant use of the ER is more likely to become a mental health insurance user, with this information JMH is able to target recurrent users of the ER as potential members.
The other example on how JMH uses predictive models is in order to enhance customer experience, is the Autism predictive model, by analyzing member’s behavior and use of different services such as family doctors, pediatric psychiatrists, etc., JMH is able
It is also with the help of analytics that the implementation of new processes is tracked and measure and how the end results are evaluated as well. Improvement Projects such as increasing the efficiency on the Claim Denial process in order to make the member aware on time if the intervention will be covered by JMH, is one example of how Continuous Improvement uses analytics. After a thorough review of the Customer Complaints, and the operational expenses driven by denied claims, it become very clear for JMH that the processes need several improvements in order to increase customer satisfaction levels and to reduce operative
 How JMH creates competitive advantage with analytics?
As mentioned above JMH ultimate goal is to improve health and overall well-being amongst its members, this goal has become its competitive advantage as well, by analyzing t the total cost of care and assuming a holistic approach on the member’s well-being; JMH is able to provide a customized level of care based on member current need.
One example of customized level of care is the Predictive Model used to identify members who will benefit from Case Management services to help them coordinate care and taking in consideration the member’s & network challenges for access to care. Once the member is identified a referral process is set in place in order to reach the member, along with different choices and educational materials for the member to choose the best fit for them. The Case Management Services is a personalized tool that offers assistance to members every step of their way in order to achieve a healthier life. The end result of the Predictive Model for Case Management services is the improvement on member’s loyalty, quality of service and of course member’s health, impacting this way the revenue & profit of the