For a peek into the future of population health management, a visit to Stanford Coordinated Care, a new clinic in northern California that is part of Stanford Health System, is in order. Staffed with three part-time physicians, one nurse and a handful of medical assistants, the clinic targets a select group of patients that health care cost accountants might just as soon send elsewhere. "We are recruiting the top 10 percent of the riskiest patients," says the clinic's co-director, Ann Lindsay, M.D. "Our patients usually have several conditions."

The clinic is paid on a specially negotiated capitated basis with Stanford's own health plan and negotiations with other commercial payers to treat their at-risk patients are under way, Lindsay says. To manage these patients - who typically have such chronic conditions as diabetes, asthma and hypertension - the clinic relies on a mini-arsenal of I.T. including an electronic health record, a clinical data warehouse and an analytics engine. "We offer an intensive model of caring for complex chronic conditions," says Lindsay, describing a model which sometimes includes house visits by physicians and other staff.

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