MX Ideas and Knowledge Base

MX Access now includes risk scores from MX Analyze and Inland Empire Health Plan (IEHP). Please review the following list for the description of each risk score.

MX Analyze Risk Scores

1. IP Admission Risk in the Future 12 Months - The probability the patient will have an inpatient admission within the next 12 months.

2. ED Visit Risk in the Future 12 Months - The probability the patient will have an emergency department visit within the next 12 months.

3. COVID-19 Mortality Risk – Identifies individuals who are at a greater risk of dying from COVID-19 if infected. A value of 0-4 indicates low risk, 4-12 moderate risk, 12-20 high risk, and 20-25 very high risk.

IEHP Member Risk Scores

1. Risk Score - The risk associated with the individual member compared to 1, where 1 is defined as an average risk based off a large external reference population.

2. Chronic Condition Count - The number of chronic conditions identified for the member. A Chronic Condition is an alteration in the structure or function of the body that is likely to last longer than twelve months and is likely to have a negative impact on the health or functional status.

3. Probability of High Total Cost - The likelihood that the member will have costs in the top 5% of the population in the following 12 months.

4. Probability of Persistent High User - The probability that the member will be in the top 20% of users for 2 consecutive years.

5. CM Risk Stratification - Risk Stratification of IEHP Membership based on Care Coordination, Diagnosis Based Markers and Risk Modeling.