MENU
The core problem
Every year, a portion of your population shifts from manageable to expensive.
Kaitlyn
HIDDEN RISK
Likely high-cost soon
Kaitlyn has Type 2 diabetes and has not seen her provider in over 12 months.
Without earlier intervention, those risks continue to escalate. And far too often, the employer does not see the full cost impact until the claim has already happened.
Converging Health identifies who is on that trajectory early and actively engages them to close care gaps, improve follow-through, and prevent avoidable cost escalation.
Calculate your savings potential
See how earlier identification and engagement can reduce costs and help prevent serious, life-changing health events.
We’ll build a tailored projection showing how much cost can be avoided by identifying and engaging rising-risk employees earlier. After submitting the form, we’ll walk you through the results so you can see exactly where the savings come from and what drives them.
How we do it
Turn risk into action
Most healthcare analytics tell you who already became expensive.
Converging Health is built to find the people whose risk is still movable, then engage them before their health trajectory turns into a major claim.
Patrick
HIDDEN RISK
Likely high-cost soon
Patrick has Stage 2 Hypertension and has not refilled his medication in 6 months.
01
Identify who is migrating toward avoidable cost
Our proprietary Whole Person Risk Score™ (WPRS™) is a predictive model that goes beyond claims and demographics. It evaluates clinical complexity, the quality and appropriateness of care a person is receiving, and how engaged they are in managing their own health. The result is a near real-time list of the specific employees who are most likely to drive future cost, with the reasons behind each score.
This is the difference between knowing your population is getting more expensive and knowing exactly which people to engage.
02
Activate them with a dedicated human guide
Risk intelligence only matters if someone acts on it. Each high-risk member is matched with a Personal Health Assistant, a real person who reaches out to the member, builds a relationship, coordinates with primary care and specialists, helps with benefits navigation, and stays accountable for follow-through.
This is where behavior actually changes. People close care gaps because someone they trust reminded them and helped them schedule it. They take their medication consistently because someone followed up. They avoid an unnecessary specialist visit because someone walked them through a better pathway.
03
Measure how risk is actually moving
Every outcome is tracked. Reporting shows risk migration over time, PMPM trend, gap closures, and engagement rates by population segment. CFOs and benefits leaders get defensible numbers that connect program activity to financial outcomes, in a format that supports fiduciary governance under CAA 2021.
Earlier engagement, lower claims, defensible numbers
A few results from clients who put the system to work
01
$17.6M in cost savings at a national convenience store chain
Activation reduced PMPY spend among 3,632 high-risk members from $12,538 to $7,691 by engaging them before risk turned into claims.
02
$16M in annualized savings at a large public transit agency
1,332 high-risk members engaged with a Personal Health Assistant. PMPM medical spend dropped from $3,048 to $2,044 over the year, a 33% reduction in a population where 83% had at least one chronic condition.
03
$14M in year-one savings at a safety-net health system
Embedding the Whole Person Risk Score into clinical workflows reduced PMPY cost from $5,102 to $4,749 across 37,318 Medicaid members and cut ED visits by 15%, with results appearing within three months of implementation.
04
A 92% engagement rate at an industrial equipment supplier
When real people own the relationship, members show up. The high-risk cohort saw a 48% reduction in migration to high-cost tiers, a 30% increase in preventive primary care visits, and $28,871 PMPY in savings.
05
An NPS of 76 among members working with a Personal Health Assistant
Healthcare programs are not known for member satisfaction. This is the prerequisite for sustained engagement, and sustained engagement is the prerequisite for sustained savings.
Info sheets and case studies
01
Whole Person Risk Score
03
Info Sheet
02
Case Study
04
Case Study
Your future healthcare cost is already taking shape.
Converging Health helps employers identify rising-risk employees, activate them with dedicated human guidance, and measure whether risk is moving in the right direction.
Start with a savings projection, or send us a message to learn more about how the model would apply to your population.