Fractal Health Triage

Provide payers with comprehensive members’ health views that enable 

proactive and preventive care at scale

What is Triage?

Triage is a solution that helps payers and providers transition from reactive care to proactive and preventive care for their members.

It enables coordinated and integrated care delivery at scale, leveraging insights from multiple data sources and predictive models, and providing feedback loops to the care team and the member. 

To achieve this, it first harmonizes member data to create a comprehensive member profile. 

It then leverages AI to identify members, prioritize, personalize, and manage interventions that can improve members’ health outcomes while optimizing utilization.

Finally, it integrates seamlessly with the care management platform to help care managers orchestrate the right actions and document feedback. 

Why should payors deploy Fractal Health Triage for its members?

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Best services combination for an individual. Tailored care plan as per treatment protocols.

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Empower members to take an active role in managing their health through health information, wellness initiatives,. etc. 

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Predict a member’s negative health event well in advance, based on past behavior and health conditions.

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Target efforts to prevent a predicted adverse health event.

Key Triage capabilities​

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Harmonized data

Various data silos about members health, demographics, financial, and social data make it hard for payers to get a comprehensive and updated member health view.


Triage harmonizes and integrates disparate data sources to build a comprehensive view of member including demographics, health, and social data.

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Integrated end-to-end solution ​

Payers often have no integrated solution to leverage member data to segment and address priority populations.

This makes is hard for them to identify the most complex and higher-cost members most likely to benefit from custom outreach and care management.

Triage’s end-to-end solution integrates an exhaustive suite of predictive models to identify members-at-health risk. It then helps prioritize, personalize, and manage interventions towards them by human agents.

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Multi-factor predictive models ​​

In most cases, the predictions of payer’s members-at-health-risk models aren’t consolidated to help build a single prediction. This makes addressing the key at-risk population very hard.

Post member identification, prioritization scores are assigned to members based on their health risk urgency, impactability, and engagement feasibility. This can help care management teams reach out to the sickest and most urgent members who are seeking help and interventions.

Triage functional modules

Fractal Health Triage enables personalized and coordinated care to payer’s Medicare members 

Get started with a Fractal Health Triage MVP in 10 to 12 weeks

For an initial minimum viable product (MVP) project, the Fractal team will customize and deploy Triage within a limited scope: 
  • One line of business: Medicare or Medicaid 
  • One member cohort: Multiple chronic conditions or chronic complex,  
  • One predictive mode: Avoidable inpatient admissions in next 6 months.  
  • To achieve this the project assumes that there is an existing members profiles database. Those profiles should have at least 75% of the required features and will only require limited solution-related profile enhancements.  


    Also, some base conditions codes and their definitions, such as chronic conditions tagging, should exist to help define the target cohorts.