Your data knows which patients will decline and which diagnoses you're missing.
You're sitting on years of EHR data, claims history, and clinical patterns. But without predictive analytics built for healthcare—integrated with your EHR, trained on your population—that data just sits there while revenue leaks.
We build custom predictive models delivering $10M+ in verified impact.
Predicting trends in Risk Adjustment Factor based on EHR and claims data
RAF Improvements
Diagnosis Accuracy
Patients Analyzed
Production Rate
Reactive care is expensive. Predictive insights change the economics.
Healthcare organizations are bleeding revenue from missed diagnoses, preventable readmissions, and late-stage interventions. The data to prevent this already exists in your systems.
Revenue cycle length
Cash trapped in A/R while denial rates hit 12%. Predictive models can cut this to 28 days.
Missed diagnoses
Risk adjustment revenue left on the table from undocumented conditions.
Readmission rates
Each preventable readmission costs $15K+. Early warning can reduce by 25%.
Labor costs
Staff spending time on reactive care instead of proactive intervention.
Risk Adjustment Factor Models for Reliable RAF Scoring
Built predictive models to identify missed diagnoses across 20,000+ patients in 7 states. The system captures chronic and episodic conditions proactively, ensuring timely clinician assessments and accurate reimbursement.
RAF Improvements
Diagnosis Accuracy
Patients Analyzed
States
"Financial analyst calculated, not vendor estimates."
See the Case Study →From data to decisions. Here's where the ROI lives.
Risk Adjustment & RAF Scoring
Predict which diagnoses are being missed based on EHR patterns. Our models achieve 90%+ accuracy in identifying undocumented conditions.
Outcome: Higher ICD/HCC recapture, audit-defensible documentation.
Readmission Risk Prediction
Identify patients at high risk of 30-day readmission before discharge. Enable targeted interventions and care coordination.
Outcome: SNF VBP penalty avoidance, improved Star ratings.
Reimbursement & Denial Prediction
Predict which claims will be denied before submission. Identify documentation gaps and payer patterns.
Outcome: Denial rates cut from 12% to 4%.
Patient Decline Detection
Predict patient deterioration 24-48 hours before clinical signs become obvious. Enable proactive interventions.
Outcome: Reduced transfers, improved outcomes.
Assistive Diagnostics
Augment decision-making with models that surface patterns and flag potential diagnoses—always with explainability.
Outcome: Faster, more accurate diagnoses.
Patient Engagement Prediction
Predict which patients are at risk of disengaging. Enable personalized outreach strategies.
Outcome: Adherence improved 65%→88%.
Predictive analytics built for value-based care.
We integrate predictive insights across the care continuum, ensuring your infrastructure is ready for value-based care transformation.
Enhanced Patient Outcomes
Predict health trajectories and intervene early with personalized treatment.
Cost Efficiency
Identify cost-saving opportunities and reduce unnecessary treatments.
Proactive Care Management
Identify trends before they become critical for timely interventions.
Improved Care Coordination
Integrate insights across teams for aligned care plans.
We don't just build models. We deliver production systems.
The difference between a proof-of-concept and a production system is everything. Our 10-step methodology is built specifically for healthcare AI.
Healthcare Data Foundation
PHI handling, multi-source EHR integration, claims + clinical + labs. HIPAA compliance from day one.
Responsible AI Build
Peer-reviewed CMS models, 90%+ accuracy, every recommendation linked to source. Built for clinical adoption.
EHR Integration
PointClickCare, Epic, Gehrimed, Elation—bidirectional, workflow-embedded. No separate login required.
KPI Accountability
Tied to your outcomes—PDPM revenue, RAF scores, denial rates. Financial analyst calculated.
Modular analytics built to scale.
Data Ingestion & Integration
Seamlessly consolidate clinical and external data sources with real-time pipelines.
Data Preprocessing
Clean and prepare high-quality inputs with automated quality checks.
Predictive Modeling
Develop and deploy accurate, explainable machine learning models.
Visualization & Dashboards
Empower stakeholders with clear, actionable visual insights.
Alerting System
Real-time notifications triggered by actionable predictions.
Compliance Layer
Built-in HIPAA safeguards ensuring data security and regulatory alignment.
We're not learning healthcare on your dime.
We've built and operated healthcare AI in production. We understand reimbursement, compliance, and clinical workflows because we live it.
User-Centric Design & Research
We uncover predictive insights by engaging with users and understanding their workflows. Solutions built around real needs.
Expert Communication & Problem-Solving
We frame the right questions and find precise answers, ensuring our solutions address specific provider challenges.
Seamless Operationalization
We integrate predictive models into practical applications—solutions that are actionable in real-world healthcare settings.
"I have worked with many technology teams during my career, and Digital Scientists is one of the best. They take the time to understand the customers' needs, deliver innovative solutions, are always professional, and work with your team as a true partner to achieve success."
Amy Severino
Chief Innovation Officer, CommuniCare
Not sure where to start? Neither were most of our clients.
Predictive analytics and data engineering are often where we begin with new healthcare partners. The first step isn't a sales call—it's a conversation with a solution architect about the problem you're trying to solve.
We'll talk through your data landscape, integration constraints, and business goals. Sometimes the answer is "you don't need custom AI." We'll tell you that too.
Start a ConversationSee How We Approach Healthcare AI
Our AI Decision Frameworks show exactly how we evaluate, scope, and deliver healthcare AI projects—with honest guidance on when to build, buy, or wait.
A/R Collection Prioritization
Predictive scoring for collection queues
High-Risk Claim Triage
Denial prediction before submission
Payer Contract Interpretation
AI-assisted contract analysis
Common questions about healthcare predictive analytics.
What is predictive analytics in healthcare?
Predictive analytics uses historical data, statistical algorithms, and machine learning to forecast future outcomes. Unlike reporting that shows what happened, predictive analytics identifies what will happen—enabling proactive interventions.
When should we choose custom over off-the-shelf?
Custom makes sense when you need deep EHR integration, your population is unique, you want predictions in workflows (not dashboards), your scale justifies it ($50M+ revenue), or generic tools have failed.
What ROI can we expect?
Verified outcomes: $10M+ RAF improvements, revenue cycles 45→28 days, denial rates 12%→4%, 25% readmission reduction. All financial analyst calculated, not vendor estimates.
How long does implementation take?
Assessment: ~1 month ($15-25K). Full implementation: 6-12 months. Our One team, concept to scale compares to 33% for internal builds that average 18+ months.
What EHR systems do you integrate with?
Production integrations with PointClickCare, Epic, Gehrimed, Elation, Acclivity, and custom EHRs. Bidirectional, workflow-embedded—insights appear where clinicians work.
Often combined with predictive analytics.
RAF / HCC Coding
Risk adjustment optimization with predictive diagnosis capture.
Revenue Cycle AI
Denial prediction, A/R prioritization, contract interpretation.
Clinical Decision Support
AI recommendations embedded in clinical workflows.
Population Health
Stratification, risk scoring, care management analytics.
Ready to discuss your predictive analytics opportunity?
30-minute call. No pitch. Just honest assessment of what's possible for your organization.
- ✓ Understand your situation and goals
- ✓ Assess opportunity and realistic ROI range
- ✓ Determine if there's a fit
Or call: 404.654.3855
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