Data transformation to reduce costs and manage risk

When you work with us, we work together to improve your outcomes.

Your data
illuminated.

At Lumiata, we drive healthcare data transformation so you can better predict costs and manage risks. 

Tap into the predictive power of the 100+ pre-trained models in our AI Model Library or build your own models using our AI Studio. 

At Lumiata, we deliver solutions to meet your needs for today and tomorrow. Our product offerings are designed to not only complement your existing business operations but to progressively evolve with your company’s AI journey.

Graphic: Lumiata AI Platform -- Data Management, AI Studio, Applications & Integration

AI Platform

The first step in the healthcare AI journey involves the preparation of raw data, including patient medical records, claims and even unstructured data like doctor’s notes. Lumiata’s AI Platform automates the ingestion, cleansing, and organization of disparate data sources into a consumable data format that makes it ready for machine learning.

Features and benefits

  • Patient data from multiple sources is synthesized into a single, comprehensive, historical health record – a unique offering in the healthcare AI space. 
  • Historical health records are then enriched using proprietary intellectual property – Lumiata Disease Codes, which are informed by more than 35,000 curated hours of clinician analysis and input.
  • The AI Platform is built in the spirit of open source, allowing insight into the process and underscoring our collaborative approach in partnering with our clients.
  • The AI Platform Integrates with existing data analytic tools like Tableau, supporting seamless business integration.

Who it’s for

  • Technology professionals
  • Data analytics teams
  • Healthcare companies interested in advancing
    their AI journey

AI Studio

With AI Studio, healthcare data scientists can quickly create machine learning models. Tap into the predictive power of pre-trained models that can be used as is or customized for your specific needs or build models from scratch. 

Features and benefits

  • A highly customized tool kit specific to healthcare accelerates the creation, deployment and maintenance of machine-learned models.  
  • A robust features management suite 
  • Tremendous cost savings can be realized by freeing up programming time.

Who it’s for

  • Data science teams
  • Technology departments
  • Data analytics groups

AI Model Library

Lumiata has created more than 100 healthcare-specific prediction tools that can support the production of intelligent health analytics. These insights can be leveraged across financial, clinical, and operational areas for improved risk awareness and cost management in healthcare organizations.


Financial prediction models

Lumiata has dozens of financial prediction models that can be customized for your use. Our most popular models include:

High-cost claimant prediction

Proactive identification of high-risk patients and their risk factors provide more effective treatment to manage conditions.

Features and benefits

  • Proven to be 5-20% more accurate than leading actuary cost prediction models.
  • Identification of expected high-cost claimants.
  • The ability to review care utilization, health conditions, and prescription medications for each claimant
  • Accurate predictions of financial risk exposure.

Who it’s for

  • Actuaries
  • Underwriters
  • HR professionals
  • Care managers

Group cost prediction

Empowers actuaries, underwriters, and account executives with easy-to-access, up-to-date and more accurate healthcare cost predictions for insured groups. 

Features and benefits

  • Proven to be 5-20% more accurate than leading actuary cost prediction models.
  • The ability to manage books of business at an enterprise level as well as by sub-populations.
  • Optimization of cash flow with more accurate financial reserve management.

Who it’s for

  • HR professionals
  • Care managers
  • Actuaries
  • Underwriters


Stop loss prediction

Streamlined workflow and AI-powered cost prediction to optimize stop loss underwriting.

Features and benefits

  • Proven algorithms to match claimants across multiple years and flag high-risk conditions.
  • Increased prediction capabilities derived from Lumiata’s proprietary data enrichment and clinical IP.

Who it’s for

  • Underwriters
  • Actuaries

Clinical
prediction models

Lumiata has dozens of clinical prediction models that can be customized for your use. Our most popular models include:

Disease onset prediction

Identification of members who are likely to develop a disease in the next 12 months.

Features and benefits

  • Predictive insights for more than 20 diseases.
  • Increased ability to optimize clinical resource allocation.
  • Predictions can guide care management design based on member risks.

Who it’s for

  • Care managers
  • HR professionals
  • Actuaries
  • Underwriters

Medical events prediction

The ability to look at a patient’s historical health record to identify risk for certain medical interventions.

Features and benefits

  • Provides early identification of patients with a likelihood of developing intervention-intensive conditions.
  • Increased ability to optimize clinical resource allocation.
  • Predictions can guide care management design based on member risks.

Who it’s for

  • Care managers
  • Actuaries
  • Underwriters

Operational

prediction models

Lumiata has dozens of operational prediction models that can be customized for your use. Our most popular models include:

Hospital admission prediction

In-depth analysis of pre-existing conditions to provide insight into patients who are at risk of being admitted to the hospital and offer the opportunity to deliver out-patient preventive interventions.

Features and benefits

  • Reduces costs associated with hospital admissions.
  • Reduces risk of secondary complications.

Who it’s for

  • Care managers
  • Actuaries
  • Underwriters

Hospital readmission

Identification of risk factors that elevate the likelihood of a hospital readmission, providing an opportunity for proactive care management to limit readmissions.

Features and benefits

  • Reduces costs associated with hospital admissions.
  • Reduces risk of secondary complications.

Who it’s for

  • Care managers
  • Actuaries
  • Underwriters

Emergency department visits

Analysis of patient population characteristics in order to predict ED visits.

Features and benefits

  • A more accurate understanding of expected ED patient volume can help hospitals better coordinate patient flow through the system, from intake to admission to discharge.
  • Scheduling of elective procedures requiring hospital stays can be better informed by understanding the volume of admissions coming from the ED.

Who it’s for

  • Care managers