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PHO uses data effectively to identify potentially high-risk, high-cost patients
Data Strategies & Benchmarks : the Monthly Advisory for Health Care Executives
|July 1, 1999
Insights
A Physician-Hospital Organization (PHO) proactively identifies high-cost, high-risk patients using data analytics. This enables early intervention through disease management and preventive care programs to reduce future healthcare expenditures.
Area of Science:
- Healthcare Management
- Health Informatics
- Preventive Medicine
Background:
- High-cost, high-risk patients often present significant financial burdens.
- Traditional billing data may not identify these patients until advanced stages of illness.
- Proactive identification is crucial for effective cost containment and patient outcomes.
Purpose of the Study:
- To outline a strategy for Physician-Hospital Organizations (PHOs) to proactively identify high-cost, high-risk patients.
- To describe methods for engaging these patients in preventive care and disease management programs.
- To demonstrate the use of data analytics for early intervention and cost avoidance.
Main Methods:
- Utilizing data analytics to identify patterns indicative of high future costs and risks.
- Implementing outreach programs to engage identified patients.
- Integrating patients into targeted disease management and preventive care initiatives.
Main Results:
- Early identification of at-risk populations before significant cost escalation.
- Successful enrollment of high-cost patients into management programs.
- Potential for substantial reduction in future healthcare spending through proactive care.
Conclusions:
- Data-driven proactive identification is essential for managing high-cost, high-risk patient populations.
- Physician-Hospital Organizations can effectively leverage data to implement preventive strategies.
- Early intervention leads to improved patient health and reduced healthcare system costs.
Abstract:
PHO uses data to avoid future costs: Potentially high-cost, high-risk patients may not show up in billing data until it's too late. Read why a PHO in the Northeast decided to go on the offensive to get its high-cost and high-risk patients into disease management or preventive care programs.