To Identify Patients for Care Management Interventions, Look Beyond Big Data

 5% of patients incur nearly 50% of United States’ health care costs, and there is growing evidence that investing resources in these individuals can improve care while decreasing costs. In kind, provider organizations are increasingly adopting high-risk care management, a strategy that relies on coordinated outpatient care to reduce costly emergency department (ED) visits and inpatient admissions. However, complex care management programs are costly in themselves, so it is important to select patients who are not only high risk but are also most likely to benefit from such programs. We now have a wealth of clinical and financial data coupled with an expanding list of analytical solutions to facilitate these choices. However, to best identify the right patients for targeted population health interventions, we need to consider other data sources as well, particularly provider insights and patient-reported data.

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