Nov 24, 2025

Mike Hoxter, CTO of Lightbeam Health Solutions, is focused on applying AI to population health management by using predictive models to enhance risk stratification for organizations with value-based care contracts. He emphasizes the importance of integrating social determinants of health along with clinical data to create more accurate predictive scores for patient outcomes, such as reducing hospital readmissions. AI enables a model to incorporate diverse data to derive more fine-tuned, actionable predictions.

Mike explains, "We're really all for optimization in value-based care plans and care management. That's really our bread and butter, which is a pretty wide net. So we have a lot of large provider organizations in either CMS MSSP, ACO REACH, or a wide range of value-based care contracts with a lot of the commercial players. The Blues, Humana, Cigna, and Aetna all have value-based care plans that they have contracts with providers. So, optimizing for performance in those contracts. Anybody who works within those is our main clientele. We also have payers that are administering value-based care plans and some hospital systems as well."

"If you're good at preventative healthcare, you prevent a lot of unnecessary healthcare. And so risk stratification is something that we do a lot of, and we use a lot of the standard models out there. We have Johns Hopkins embedded into our application. We have all of the different HCC models for Medicare Advantage, CDPs for Medicaid, but then also we have a suite of internal machine-learning-based models, which, I think, is funny - we've gotten to a point where there's such a thing as traditional AI, which is what it's called."

#LightbeamHealthSolutions #PopulationHealth #ValueBasedCare #VBC #VBCEnablement #AI #SDOH #RemotePatientMonitoring #Providers #Payers #ACO

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