UnityPoint Health

UnityPoint Health identified that patients with complex chronic health conditions were overutilizing healthcare services, particularly during transitions from hospital to ambulatory care. Despite access to large data volumes, clinicians lacked timely insight into care across acute and ambulatory settings. The organization needed to predict which high-risk patients could benefit from care management program enrollment to prevent unnecessary ED visits and unplanned admissions.

UnityPoint Health deployed Health Catalyst's Data Operating System (DOS) platform along with a suite of AI-powered analytics tools including a Readmission Heat Map, Population Health Toolkit, Leadership Dashboard, and Outcomes Analyzer. These tools incorporate chronic health data, social data, admission probability, and readmission risk to risk-stratify patients and prioritize them for care management engagement. The framework enabled integrated care coordination across acute and ambulatory settings with shared goals and tools.

Over 30 months since program inception, UnityPoint Health reduced healthcare spending by more than $32.2M, driven by a 54.4% relative reduction in hospital admissions and a 39% relative reduction in ED visits. Patients gained over 11,000 more days at home and experienced nearly 2,000 fewer ED visits.

• AI-powered risk stratification at scale enables care managers to proactively intervene before unnecessary utilization occurs, not just react after the fact.
• A single source of truth across disparate acute and ambulatory systems is foundational to effective population health management.
• Collaboration between clinicians and analytics teams is essential for building tools that are both technically sound and clinically actionable.