Proactive Care in Action: How Pearl’s Predictive Insights Helped Prevent an Unplanned Hospital Admission

Managing care for Medicare beneficiaries with multiple chronic conditions can be incredibly complex. Patients with comorbidities such as congestive heart failure, type 2 diabetes, and obesity face heightened risks of complications that may lead to unplanned hospital admissions.¹ As the number of these patients rises, providers often face the challenge of knowing which patients to prioritize for timely intervention.

That’s where Pearl Health’s predictive technology comes in, offering a data-driven solution to support primary care providers (PCPs) in identifying and managing high-risk patients. PCPs gain actionable insights to help prevent unplanned hospital admissions, improve chronic care management, and improve performance in CMS’ All-Cause Unplanned Admission for Patients With Multiple Chronic Conditions (UAMCC) Quality Measure.²

Here’s how Pearl’s technology made a difference in one patient’s care journey:

Patient Profile: Jane Smith

• Female, 81 years old³
• Healthcare History: Congestive heart failure, type 2 diabetes, obesity, and tobacco dependence
• Recent History: One hospital admission within the previous 12 months

Pearl’s Predictive Signal in Action

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The Impact

Through timely intervention powered by Pearl’s predictive insights, Jane avoided an unplanned hospital admission. The benefits extended far beyond cost savings:

• $16,545⁴: Average savings for each unplanned admission Pearl helps prevent.
• Improved chronic condition management: Jane gained better control over her health.
• Stronger patient-provider relationship: Her PCP’s proactive engagement reinforced trust and continuity of care.

Why This Matters

Preventing unplanned hospital admissions isn’t just about reducing healthcare costs — it’s about transforming the patient experience. By leveraging predictive technology, Pearl Health enables PCPs to focus on high-risk patients, manage chronic conditions more effectively, and deliver the right care at the right time.

For patients in vulnerable populations like Jane, this approach doesn’t just improve outcomes; it reshapes the relationship between patients and providers, creating a foundation for healthier, more empowered lives.