Fractal Health Triage (“Triage”) is a solution for payers that leverages a comprehensive view of the member to programmatically select the ones that could benefit the most from 1:1 engagement from the care team. By engaging the care team with those members-at-risk, healthcare outcomes can be significantly improved, and member utilization can be optimized.

Triage has multiple steps:

1. Segment population into RISK cohorts based on their health profile
   
2. AI models, clinical triggers and data triggers help identify members-at-risk including in-patient, readmission, high cost, etc. Those assign a risk score and the top n% riskier are shortlisted.
   
3. Gaps-in-care are identified through clinical systems for shortlisted members-at-risk. The members-at-risk are prioritized based on impactability, likelihood of engagement and severity of their health risk. The top n% prioritized members make it to the “needs intervention” bucket.
   
4. Additional information is added to the “needs intervention” list including personal preferences, channel preferences, social determinants, digital engagement etc.
   
5. The need intervention group is then passed onto care managers with all the intelligence to help guide them on how to interact with the members and help manage/mitigate their health risk.
   
6. Feedback from members, care management team is captured through the care management platform and used to improve CC over time.