Scott Stratton

Health Plans & Payers Healthcare Industry Experts

Scott Stratton

Scott Stratton, MPH, Business Development, joined Veradigm in its 2019 acquisition of Pulse8 where, as an initial employee and Chief Data Scientist, he created patent-pending approaches to managing gaps in care, helping bring payers revenue while paring multiples in waste.

AREA OF EXPERTISE

Analytics for risk adjustment and related management of gaps in care Case mix classification and analytics Program and product innovation and development

Scott Stratton, MPH, Business Development, joined Veradigm in its 2019 acquisition of Pulse8 where, as an initial employee and Chief Data Scientist, he created patent-pending approaches to managing gaps in care, helping bring payers millions in revenue while paring multiples in waste.

His work has been cited by Computerworld as a Global Best Practice in BI for Fortune 100s; by URAC for reducing diabetes drug errors; by the International Foundation of Employee Benefit Plans for the first urban Child Health Plus program which evolved into the national SCHIP. A major Pharma used for >15 years a program he helped design to manage all Phase II-IV human drug trials in 80 countries. In his first start-up he designed one of the first systems to manage hospital quality via integrated UM, infection control, and OR case review.

He trained with the creators of DRGs, one as thesis advisor for the econometrics behind RUGs that now pay SNFs. He created one of the first case mix-adjusted provider risk-sharing programs and co-founded it global fee-based subsidiary to manage specialty care, a model for CMS Bundled Payments for Care.

Scott earned his MPH from Yale and BA from Carleton College (Philosophy), is often heard at forums like RISE, and has been profiled by American Demographics and CIO magazines.


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The Future of Risk Adjustment Analytics: Using Dynamic Intervention Planning for Precision Targeting

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References to published articles by this expert

  • Effect Of Utilization Review In A Fee-For-Service Health Insurance Plan. N Engl J Med 1995 Nov 16;333(20):1326-30. DOI: 10.1056/NEJM199511163332006. A NEJM Special Article, first study to quantify presence of Sentinel Effect in admission pre-authorizations via randomized case-control study.
  • Informatics in managed care: Health Information Management adds value to data. Journal of AHIMA, 01 Sep 2001, 72(8):58-62. PMID: 1571248. Part of series that won Gold Medal from American Association of Health Care Publishers.
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