Healthcare organizations use a range of tools and practices to identify and stratify high-risk, high-cost patients and determine appropriate interventions. Most critical to the stratification process is clinical patient data, say an overwhelming 87 percent of respondents to the Healthcare Intelligence Network’s (HIN) inaugural survey on Stratifying High-Risk Patients.
However, obtaining and verifying patient data remain major challenges for many respondents. Following are 10 more statistics from our survey.
- Hospital readmissions is the metric most favorably impacted by risk stratification tools, according to a majority of respondents.
- In addition to high utilization, clinical diagnosis is considered a key factor in stratifying high-risk patients, according to 16 percent of respondents.
- Case management as a post-stratification intervention is offered by 83 percent of respondents; health coaching by 56 percent.
- Reducing heart failure (HF), pneumonia (PN), and atrial myocardial infarction (AMI) are among the greatest successes of risk stratification programs.
- Diabetes is considered the prominent health condition among high-risk populations, according to 37 percent of respondents; other prominent conditions include hypertension (20 percent) and mental health/psychological issues (15 percent).
- Physician referrals are cited by 76 percent of respondents as an important input for stratification, followed by case/care manager referrals (71 percent).
- Home health and/or home visits are available to risk-stratified populations of 56 percent of respondents.
- LACE (Length of stay, Acute admission, Charleston Comorbidity score, ED visits) is considered the primary indice and screen to assess health risk, according to 33 percent of respondents.
- Nearly half of respondents (45 percent) cite high utilization of the emergency department (ED) or hospital as the most critical attribute of high-risk patients.
- While more than half of respondents have a program in place to identify and risk-stratify complex cases, the majority admit it is too early to tell the ROI achieved.
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