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Reducing Potentially Preventable ED Visits with Data-Driven Member Engagement
Points of Light 2026 Case Study 22
Sentara Health, an integrated payer-provider in Virginia, faced rising potentially preventable ED (PPED) utilization that increased costs, strained ED capacity, and pressured its medical loss ratio, despite available but underutilized clinical assets. Partnering with N1 Health, the organization used predictive analytics and consumer intelligence to segment high-risk members and deploy targeted digital and telephonic outreach with warm transfers to primary care, urgent care, telehealth, and mobile community clinics. Executive leadership aligned payer and provider workflows and expanded in-network access to alternative sites of care. The initiative reduced PPED visits by over 50% and generated $515,000 in savings.
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This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2026 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.