Your Sickest 5% Are Telling You Everything
The top 5% of your attributed lives drive 52% of total spend. Populis maps every clinical, social, and utilization signal in that cohort — and delivers the intervention playbook that bends the curve before your next payer renegotiation.
Avoidable spend identified across client portfolios
Health systems and Medicaid programs served
Median time to measurable PMPM reduction
What happens when our largest payer shifts to full capitation next contract cycle?
Median unmanaged risk exposure for a 500-bed system entering full capitation without stratified intervention protocols
Full capitation doesn't create new risk — it makes visible the risk you've been carrying invisibly. The systems that enter capitation confidently have already mapped their attributed population by clinical complexity, social vulnerability, and historical utilization. They know which 4,200 lives will drive 60% of their cost.
Populis builds that map in 90 days using your claims, EHR, and publicly available SDOH data. We layer in our national benchmark database — 14 million attributed lives across 47 client systems — to identify where your cohort diverges from peer performance. The output is a risk-stratified intervention matrix: which patients, which interventions, which sequence, which timeline.
Before your next payer negotiation, you walk in knowing your number. Not a range. A number — defensible, auditable, and supported by the same actuarial methodology your payer is using on the other side of the table.
How do we stratify our attributed lives when our data infrastructure is still maturing?
Of actionable stratification intelligence can be derived from claims data alone — no EHR integration required to begin
The most common reason health systems delay population health work is waiting for a clean data environment. That delay is itself a cost. Every quarter without stratification is a quarter where high-risk patients cycle through the ED instead of a care management pathway.
Populis begins with what you have. Our stratification methodology is tiered: Tier 1 uses only claims — diagnosis codes, utilization patterns, pharmacy fill rates, and geographic clustering. This alone identifies your top 5% with 91% accuracy against clinical validation studies. Tier 2 adds EHR data where available. Tier 3 incorporates SDOH indices, community health worker notes, and social service utilization.
Most clients reach actionable stratification within 60 days of engagement — before any technology infrastructure changes are complete. The intervention programs run in parallel with any platform migrations you have underway.
Can you show us outcomes that survived a payer audit — not just internal projections?
PMPM reduction achieved within 24 months across our three largest health system engagements, validated by independent actuarial review
Every health system has seen the vendor deck that shows 40% cost reduction in a cherry-picked cohort with no comparison group. We don't build those decks. Our outcomes methodology uses difference-in-differences analysis against matched control populations — the same standard CMS applies to ACO performance measurement.
Across our three largest engagements — a 1,200-bed integrated delivery network, a regional Blue Cross attributed population of 180,000 lives, and a state Medicaid managed care organization — the validated 24-month PMPM reductions ranged from $198 to $261. All three passed payer audit. All three were used as evidence in subsequent contract renegotiations.
We can provide redacted outcome reports and actuarial validation letters under NDA before you sign an engagement agreement. We believe you should see the evidence before the proposal.
Can a system like ours actually survive the full transition to value-based care?
Of health systems that achieve value-based contract profitability share one characteristic: stratification-led care management initiated before the contract went live
The honest answer is: it depends on which 20 decisions you make in the next 36 months. The systems that fail the transition don't fail because value-based care is structurally unworkable for them — they fail because they entered contracts before they could manage the risk they accepted.
The readiness profile we build for every prospective client maps five dimensions: clinical stratification maturity, SDOH integration depth, care management capacity, network leakage rates, and data infrastructure. The gap between where you are and where you need to be is almost always smaller than it looks — but it requires a sequenced intervention plan, not a platform purchase.
We have worked with systems that entered this conversation at 35% readiness and reached contract-ready status in 18 months. We have also told three prospective clients that their timeline was unrealistic and recommended they renegotiate their contract terms before engaging us. That kind of candor is what a confidential briefing is for.
Population Health
Readiness Index
Benchmarks drawn from 47 health systems and 12 state Medicaid programs. Covers clinical stratification maturity, SDOH integration depth, care management capacity, and network leakage rates — segmented by system size and payer mix.
Download Free Report →Readiness Index
47 health systems · 12 Medicaid programs
The playbook already exists.
We built it for your ZIP codes.
In a 45-minute confidential briefing, we map your highest-cost cohorts against our national benchmark database and show you exactly where the spend is concentrated — before you've signed anything.
Cohort benchmark
Your top-5% compared to 47 peer systems by diagnosis, utilization, and ZIP code.
Intervention gap map
Where clinical and social interventions are absent in your highest-risk population.
PMPM reduction range
Conservative and aggressive scenarios based on your current payer mix and contract structure.