Risk scores and risk stratification techniques are foundational for any successful population health management program. What are some of the considerations for developing this data?
Population health management requires providers to maintain a delicate balance between taking a long view of generalized patient trends and focusing personal attention on the individual and the distinctive circumstances that will influence her journey towards better health.
Organizations can develop risk scores by examining large cohorts of patients with similar characteristics, extracting key clinical and lifestyle indicators from those cases, and using algorithms to chart how those factors influence ultimate outcomes.
They can then compare other patients exhibiting similar clinical patterns to the validated historical data, which may help predict what will happen in the future.
Getting as far ahead of negative outcomes as possible is the key to successfully transitioning to a value-based world.
PVBM Technology looks at two aspects of health. We consider both social determinants of health for non-medical needs as well as physical health risks. With PVBM Technology a health organization can present to their members a tool that engages all members and then scores the individual to present overall health stratification. Each organization member is presented with an application that will guide them to answer specific questions in both medical and non-medical domains.
When we couple the Risk Stratification with SDOH overlay, our proprietary AI technology can then determine medical necessities for each individual patient with regard to assessments, diagnostics and ancillaries. This provides us with both a cost for caring for these populations, as well as a revenue target in the Medicare or fee for service sector. We also have programs that work for capitated or risk sharing models.