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Predictive Analytics

Using a proprietary predictive analytics engine from our vendor partner, RxAnte, WellCare is able to identify members who are at risk for misusing an opioid drug after the first prescription is written.

The Risk of Unsafe Use Score TM

  • Applies to both Medicaid and Medicare
  • Applies to members receiving an opioid Rx in the previous six months
  • Identifies members at risk for unsafe use of prescription opioids
  • Predicts the likelihood that an opioid user will be diagnosed with unsafe opioid use in the next 1-year period
    • Makes separate predictions for new users and continuing users
    • Assigns a risk score to each member from 1–10. (We will only outreach to members with a risk score of 10.)
Last Updated On: 12/13/2020
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