Managing Health Populations

Healthier Members, Lower Costs

Population health management shifts health plan strategy from reactive claims payment to proactive member engagement — identifying high-risk individuals before they become high-cost, and connecting them to the care and support that keeps them healthy. Hetasalvation builds and manages PHM programs that deliver measurable improvements in quality and cost.

From predictive risk stratification to targeted outreach campaigns and disease management programs, our PHM services create the conditions for better member health at scale.

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PHM Services

Population Health Solutions

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Risk Stratification

Predictive models that identify members at high risk for adverse events, high utilization, or preventable hospitalizations — enabling proactive intervention.

Predictive risk scoring models
Claims-based risk stratification
Social determinants of health (SDOH) integration
HCC risk adjustment modeling
Risk cohort identification

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Chronic Disease Management

Structured programs for diabetes, hypertension, COPD, CHF, and other chronic conditions — supporting members to manage their health and reduce complications.

Diabetes management programs
Hypertension management
CHF / COPD management programs
Medication adherence support
Remote monitoring integration

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Care Gap Closure

Targeted outreach to close HEDIS and quality measure care gaps — preventive screenings, annual wellness visits, vaccinations, and chronic disease monitoring.

HEDIS care gap identification
Member outreach campaigns
Provider care gap reporting
Preventive care reminders
AWV & TCM outreach

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Member Health Coaching

One-on-one health coaching for high-risk members — behavior change support, self-management education, and care coordination across the health system.

Telephonic health coaching
Condition-specific self-management
Lifestyle modification programs
Mental health integration
Health literacy support

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Social Determinants of Health

SDOH screening, referral, and program integration — addressing food insecurity, housing instability, transportation barriers, and social isolation that drive health disparities.

SDOH screening programs
Community resource referral
Community health worker programs
Housing & food security programs
SDOH data integration

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PHM Analytics & Reporting

Population health dashboards that track program enrollment, engagement, outcomes, and cost savings — demonstrating PHM ROI to leadership and regulators.

Program enrollment & engagement tracking
Clinical outcome measurement
Cost savings analysis
HEDIS measure improvement tracking
CMS quality program reporting

Population Health Management