Stratifying High-Risk Patients in Value-Based Healthcare: Procurement, Integrity of Clinical Data Challenge Segmentation
While the tactic of stratifying high-risk high-cost individuals for targeted care management is championed in a value-based industry, the procurement of clinical data and verifying data integrity are the top challenges of segmenting patients by health risk, according to a new HINtelligence report. One-third of organizations stratifying patients by health risk report reductions in hospital readmissions.
Sea Girt, NJ, November 10, 2014 --(PR.com)-- Most critical to the process of segmenting patients by health risks for care coordination purposes is the availability of rich 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 in the stratification process for many respondents, who view risk segmentation as integral to value-based care.
Across the healthcare continuum, a range of tools and practices help to identify and stratify high-risk, high-cost patients and determine appropriate interventions. Two-thirds of healthcare organizations responding to HIN's September 2014 survey currently risk-stratify the populations they serve.
In addition to the requirement for clinical information, hospital discharge data (62 percent) and pharmacy data (49 percent) are also highly sought in the risk stratification process.
Hospital readmissions was the metric most favorably impacted by health risk stratification, according to respondents; 65 percent reported a decrease in hospitalizations as a result of patient segmentation.
More results from the survey are available in the latest HINtelligence report, Population Health Management in 2014: Surge in 'Big Data' Tools Transforms Care Coordination, a complimentary downloadable HIN white paper.
Download this white paper on Stratifying High-Risk Patients in 2014 at http://www.hin.com/library/registerStratifyingHighRisk2014.html.
News Facts: HIN's white paper, Stratifying High-Risk Patients in 2014: Procurement, Integrity of Clinical Data Challenge Segmentation, summarizes September 2014 responses from 88 hospitals/health systems, health plans, primary care practices and others on their approaches to identifying and segmenting high-risk, high-cost patients.
Other data highlights from the survey include the following:
-The case manager has primary responsibility for patient stratification, say 74 percent of respondents; for 9 percent of respondents, health coaches and primary care physicians have primary responsibility.
-Nearly half of respondents (45 percent) cite the red flag of high utilization of the emergency department (ED) or hospital as the most critical attribute of high-risk patients.
-LACE (Length of stay, Acute admission, Charleston Comorbidity score, ED visits) is the most common indice and screen employed by respondents to assess health risk, according to 33 percent of respondents.
-Case management as a post-stratification intervention is offered by 83 percent of respondents; health coaching by 56 percent.
Improved management of patients with heart failure (HF), pneumonia (PN), and atrial myocardial infarction (AMI) was another frequently reported success related to risk stratification, respondents noted.
Download this white paper on Stratifying High-Risk Patients in 2014 at http://www.hin.com/library/registerStratifyingHighRisk2014.html.
Quote attributable to Melanie Matthews, HIN Executive VP and COO:
"Identification and care coordination of high-risk, high-cost patients is an essential first step in population health management. When leveraged organization-wide and supported by care coordination protocols, patient segmentation has been shown to improve cost and quality outcomes, thus enhancing value-based reimbursement."
Review Melanie Matthews's profile at http://www.hin.com/bios.html#mm
Please contact Patricia Donovan to arrange an interview or to obtain additional quotes.
About the Healthcare Intelligence Network — HIN is the premier advisory service for executives seeking high-quality strategic information on the business of healthcare. For more information, contact the Healthcare Intelligence Network, PO Box 1442, Wall Township, NJ 07719-1442, (888) 446-3530, fax (732) 449-4463, e-mail info@hin.com, or visit http://www.hin.com.
However, obtaining and verifying patient data remain major challenges in the stratification process for many respondents, who view risk segmentation as integral to value-based care.
Across the healthcare continuum, a range of tools and practices help to identify and stratify high-risk, high-cost patients and determine appropriate interventions. Two-thirds of healthcare organizations responding to HIN's September 2014 survey currently risk-stratify the populations they serve.
In addition to the requirement for clinical information, hospital discharge data (62 percent) and pharmacy data (49 percent) are also highly sought in the risk stratification process.
Hospital readmissions was the metric most favorably impacted by health risk stratification, according to respondents; 65 percent reported a decrease in hospitalizations as a result of patient segmentation.
More results from the survey are available in the latest HINtelligence report, Population Health Management in 2014: Surge in 'Big Data' Tools Transforms Care Coordination, a complimentary downloadable HIN white paper.
Download this white paper on Stratifying High-Risk Patients in 2014 at http://www.hin.com/library/registerStratifyingHighRisk2014.html.
News Facts: HIN's white paper, Stratifying High-Risk Patients in 2014: Procurement, Integrity of Clinical Data Challenge Segmentation, summarizes September 2014 responses from 88 hospitals/health systems, health plans, primary care practices and others on their approaches to identifying and segmenting high-risk, high-cost patients.
Other data highlights from the survey include the following:
-The case manager has primary responsibility for patient stratification, say 74 percent of respondents; for 9 percent of respondents, health coaches and primary care physicians have primary responsibility.
-Nearly half of respondents (45 percent) cite the red flag of high utilization of the emergency department (ED) or hospital as the most critical attribute of high-risk patients.
-LACE (Length of stay, Acute admission, Charleston Comorbidity score, ED visits) is the most common indice and screen employed by respondents to assess health risk, according to 33 percent of respondents.
-Case management as a post-stratification intervention is offered by 83 percent of respondents; health coaching by 56 percent.
Improved management of patients with heart failure (HF), pneumonia (PN), and atrial myocardial infarction (AMI) was another frequently reported success related to risk stratification, respondents noted.
Download this white paper on Stratifying High-Risk Patients in 2014 at http://www.hin.com/library/registerStratifyingHighRisk2014.html.
Quote attributable to Melanie Matthews, HIN Executive VP and COO:
"Identification and care coordination of high-risk, high-cost patients is an essential first step in population health management. When leveraged organization-wide and supported by care coordination protocols, patient segmentation has been shown to improve cost and quality outcomes, thus enhancing value-based reimbursement."
Review Melanie Matthews's profile at http://www.hin.com/bios.html#mm
Please contact Patricia Donovan to arrange an interview or to obtain additional quotes.
About the Healthcare Intelligence Network — HIN is the premier advisory service for executives seeking high-quality strategic information on the business of healthcare. For more information, contact the Healthcare Intelligence Network, PO Box 1442, Wall Township, NJ 07719-1442, (888) 446-3530, fax (732) 449-4463, e-mail info@hin.com, or visit http://www.hin.com.
Contact
Healthcare Intelligence Network
Patricia Donovan
732-449-4468
www.hin.com
https://twitter.com/H_I_N
Patricia Donovan
732-449-4468
www.hin.com
https://twitter.com/H_I_N
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