For healthcare organizations intent upon reaping quality and clinical rewards from value-based reimbursement, the identification and stratification of high-risk, high-cost patients is a crucial foundational step.
2014 Healthcare Benchmarks: Stratifying High-Risk Patients captures the tools and practices employed by dozens of organizations in this prerequisite for care management and jumping-off point for population health improvementódata analytics that will ultimately enhance quality ratings and improve reimbursement in the industry's value-focused climate.
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Results from risk stratification can range from helping a Type 2 diabetes patient get glucose levels under control to reducing avoidable hospital readmissions for a cohort of heart failure patients.
In the last year, the Centers for Medicare and Medicaid Services (CMS) have dedicated significant resources to programs targeting "super-utilizers"beneficiaries with complex, unaddressed health issues and a history of frequent encounters with healthcare providers.
This 40-page report, based on responses to HIN's inaugural industry survey on health risk stratification, assembles a wealth of metrics on indexing by severity the most vulnerable patients and health plan members and matching them to risk-related interventionscase management, health coaching, home health monitoring, or more intensive management.
Respondents also describe in their own words their challenges, successes, results and future plans related to health risk stratification.
This benchmark report is designed to meet business and planning needs of health plans, employers, health coaching and disease management, case management managed care organizations, physician organizations, health systems, health IT companies and others by providing critical benchmarks in stratifying high-risk patients.
Supported with dozens of graphs and tables, this 2014 market research documents emerging trends in health risk stratification and assembles a comprehensive set of best practices and benchmarks on health risk stratification approaches and its impact on clinical, financial and operational metrics.
The report, which breaks down findings by high-responding industry sectors, is inclusive of the following data set:
and much more.
Prevalence of programs to identify and risk-stratify high-risk, high-cost individuals;
Attributes of high-risk patients;
Components of risk stratification infrastructure;
Patient data considered during stratification;
Indices and screens used to assess risk;
Interventions available to high-risk individuals;
The most successful tools, process or workflows employed in risk stratification programs, in respondents' own words; and
ROI, successes and challenges related to health risk stratification.
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