Cerner Innovation, Inc.

John Matthew Sugden

Sasanka Are

Brian Thurston

Improved risk categorization is provided for clinical decision support and forecasting future health care spend. A risk index is provided that improves on other risk stratification models by synthesizing electronic medical records and health questionnaires with an individual patient's claim histories. Machine learning algorithms catalogue patients into distinct group clusters, based on risk which may be associated with annual health care spending, thereby enabling administrators to forecast future health care spending on the individual and population level.

Machine learning clinical decision support system for risk categorization

Systems, methods and computer-readable media are provided for predicting probability of a clinical invoice being paid by a specified date. A clinical invoice is a request for payment. The clinical invoice can take the form of an insurance claim, bill to a person (e.g., self-insured, co-pay), or submission to a government entity (e.g., Medicare, Medicaid). Healthcare facilities do not know how long they will have to wait between submitting an invoice and receiving compensation from government, insurance, or other payers. The methods described herein can be used to estimate the probability of payment occurring by a specified date. This information can be used to triage outstanding claims for investigation and to improve outstanding cash forecasts. The technology described herein uses survival curves to estimate when an invoice will be paid.

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Lee's Summit, MO, United States of America

John Matthew Sugden