Transform Hidden Risk Into Predictable Savings

AI-powered analytics that identify and reduce healthcare costs from AUD/SUD populations before catastrophic events occur

30% of medical loss from <20% of population
72hr post-crisis engagement window
5x ROI within 18 months
See RiskWell in Action Download White Paper
Intervention Point
Without RiskWell With RiskWell

The Hidden Crisis in Your Member Population

Invisible Until It's Too Late

AUD/SUD patients remain hidden in claims data until catastrophic events drive massive costs

Engagement Barriers

Traditional outreach fails with digitally underserved, trauma-affected populations

Network Leakage

Ghost providers and inadequate networks drive costly out-of-network utilization

Five Pillars of Predictive Behavioral Health Intelligence

A comprehensive platform designed specifically for health plan success

01

Predictive Identification & Risk Stratification

Multi-modal AI that surfaces hidden risk before catastrophic events

  • Temporal Risk Graphing with abnormal spike alerts
  • Pseudo-diagnostic Suggestion Engine
  • SDOH-layered segmentation
  • Deep claims analytics with NLP
Outcome: Top 1% Watchlist with actionable cohort tagging
02

AI-Powered Engagement Recommendations

Behavioral science meets AI for unprecedented member connection

  • Narrative Generation AI with trauma-informed principles
  • Digital Footprint Analysis
  • Moment-of-Opportunity Detection
  • Reinforcement learning optimization
Outcome: 3x engagement rates with resistant populations
03

Network Performance & Leakage Analytics

Real-time network optimization and cost containment

  • Referral Integrity Mapping
  • Ghost Provider Detection
  • MAT Provider Saturation Index
  • Automated leakage forecasting
Outcome: 25% reduction in out-of-network spend
04

Program Design Simulation Tools

Test interventions before launch with behavioral economics modeling

  • Behavioral Twin Matching
  • Intervention Elasticity Modeler
  • Scenario Library with peer benchmarks
  • Time-to-savings visualization
Outcome: Confident ROI forecasts for board approval
05

Outcomes & ROI Reporting Layer

Prove value with transparent, defensible attribution

  • Attribution Sensitivity Engine
  • Cross-Intervention Interaction Modeling
  • Compliance-ready audit trails
  • NCQA/CMS/HEDIS-aligned outputs
Outcome: Clear ROI documentation for every dollar spent

Calculate Your Potential Savings

15%
Hidden At-Risk Members 17,000
Potential Annual Savings $18.3M
ROI Timeline 4-6 months

Proven Results Across Health Plans

45% Reduction

in ER utilization for engaged members

3x Higher

engagement rates vs. traditional outreach

$

$4.20 Saved

for every $1 invested within 18 months

Success Stories

Regional Health Plan 500K Members
"RiskWell identified 12,000 high-risk members we completely missed. The ROI was evident within 90 days."
VP of Population Health
67% cost reduction 4.8x ROI
Medicaid MCO 1.2M Members
"The engagement recommendations transformed our outreach. We're finally reaching the unreachable."
Chief Medical Officer
3x engagement $23M saved
National Payer 5M+ Members
"Network leakage analytics alone saved us millions. This platform pays for itself."
Director of Behavioral Health
25% leakage reduction 6-month payback

Seamless Integration With Your Ecosystem

Claims Systems Claims Systems
Care Management Care Management
BI Dashboards BI Dashboards
EHR Systems EHR Systems

API-first architecture ensures deployment in weeks, not months

Ready to Transform Your Behavioral Health Strategy?

See how RiskWell Labs can identify hidden risk and drive measurable savings in your population

Schedule Your Demo Download White Paper

Join leading health plans already saving millions with RiskWell

Let's Discuss Your Population

Our behavioral health experts are ready to show you how RiskWell can transform your AUD/SUD outcomes

30-minute personalized demo
ROI analysis for your population
Implementation roadmap

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