Symmetry Episode Risk Groups®

Episode Risk Groups® (ERG®) use episodes of care as markers of risk rather than the diagnoses from individual medical encounters so the focus is placed on the key information describing a patient's underlying condition instead of the individual services.

The enhanced predictive accuracy of ERG can lead to a better understanding of variations in medical costs and practice and how they relate to differences in health risk.

Symmetry Suite Integrated Platform

Overview

Features

Enhanced predictive accuracy

The enhanced predictive accuracy of ERG^® can lead to a better understanding of variations in medical costs and practice and how they relate to differences in health risk. More valid, health-based payments, precise comparisons of provider performance, and the effective targeting of patients and populations are the intended result.

Understand member health risk

Measure health risk with a rich mix of indices
Rate employer groups
Compare provider performance
Identify higher-risk patients
Allocate resources more effectively

Powerful health risk assessment

Because episodes of care can incorporate pharmaceutical data, ERG also uses the information available from a patient's use of prescription drugs—a feature that has had only limited or no use in existing health risk assessment models. The result is a powerful, cost-effective, and practical alternative to existing health risk assessment methodologies.

A new approach to risk assessment

Like many existing risk assessment methodologies, ERG uses basic inputs such as the diagnoses recorded on medical claims and demographic variables to predict health risk. Significantly, however, ERG uses episodes of care as markers of risk to better measure member health risk.