Vigilance and Accuracy

Inside most health plans is a population of members who have an undetected, uncontrolled or misdiagnosed chronic autoimmune disease or condition— and, therefore, represents a guaranteed financial risk.

Decode Health is a data analytics company delivering unique, actionable detail to care management and analytics firms to address the hidden and expensive chronic autoimmune disease risk in their clients’ plans. We detect and continuously monitor the target population to anticipate disease progression allowing your care managers to be proactive in working with patients and their providers.

How We Do It

Tackling autoimmune disease quickly and accurately requires the investigative minds of immunologists AND the analytical speed, scale and efficiency of machine learning.
Decode Health is one of the few companies in the world that has both. That’s what sets us apart.


Client sends healthcare claims and other structured data


Decode layers its proprietary data + social determinants of health


Decode trains, tests, and optimizes models to uncover patterns and score populations


Decode identifies at-risk patients and delivers actionable information to care managers


Care managers work with at-risk patients and their providers to impact care plans and reduce medical spend

The Bottom Line: Significant cost savings opportunity
in autoimmune disease and related conditions


Average total healthcare
spend PMPY

$15K – $125K

Range of autoimmune
spend PMPY


Savings potential
on annual autoimmune spend


Projected ROI
using Decode’s platform

Find Your
Autoimmune Problem

Your Autoimmune Impact

  • Up to 16% of your managed population has one of the diseases and conditions we detect and monitor.
  • They cost your plans and employers millions.
  • Savings from correcting misdiagnosis is significant in the first year.
  • 25% of claims are categorized with ill-defined R diagnosis codes and some of that population will likely have an autoimmune disease.
How big is your number?