Member Risk Stratification Methodology Sample Clauses

The Member Risk Stratification Methodology clause defines the process by which members are categorized based on their health risk levels. Typically, this involves using data such as medical history, claims, or predictive analytics to assign members to different risk groups, which can then inform care management or resource allocation. The core function of this clause is to ensure a standardized and transparent approach to identifying high-risk individuals, thereby enabling targeted interventions and more efficient management of healthcare resources.