Percolator systems and methods

A computer program product embodied in a non-transitory computer-readable medium, the computer program product comprising an algorithm adapted to effectuate a method, the method comprising:

• receiving a plurality of data related to healthcare of a plurality of members;
• applying a risk-determination algorithm to the received data, the risk-determination algorithm being based on a predetermined set of risk factors;
• assigning an acuity level to each member based on results of the risk-determination algorithm;
• providing a plurality of triggers, each trigger being related to a healthcare issue and being associated with a predetermined weight;
• calculating an outreach score for each of the plurality of members based on applicability of each of the plurality of triggers;
• and
• providing an outreach plan for the plurality of members based on the acuity levels and outreach scores.

A system comprising:

• a rules database configured to maintain a plurality of business rules used to evaluate member data associated with a plurality of members;
• a risk-evaluation unit configured to assign each of the plurality of members to an acuity level based on application of one or more of the business rules that are deemed related to risk-assessment;
• a ranking unit configured to calculate a score for each of the plurality of members based on one or more of the business rules;
• and
• an assignment unit configured to provide an outreach workflow based on the acuity levels and scores of the members, wherein the scores determine which members are flagged for outreach and the acuity levels determine one or more characteristics of each outreach.