With penalties for readmissions, risk-based payment models, and new mandates to measure and improve community health, its more important than its ever been to identify high-risk patients before they show up in the ED. Bostons Steward Health Care Network, one of Medicare's 33 Pioneer ACOs, has been using a combination of claims and clinical data, sophisticated analytics, and the gut feelings of its physicians to stratify its patient population and target certain layers for special interventions. Vice President of Population Health Dominique Morgan-Solomon will share some of the organizations secrets during a HIMSS14 presentation titled Data-Driven: A Pioneer ACO Applies Data to Improve Patient Care on Monday, Feb. 24 at 11:30 a.m. -12:30 p.m.
Theres a misperception that you need to focus all your efforts and resources on the top one or five or ten percent [of high-cost patients] to manage your costs, she says. In theory it makes sense, but if you dig into population level data you find that the top five percent is things you couldnt have managed, like cancer or a car accident. Those people arent going to stay at that level from a cost perspective.
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