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Guide to Health Risk Assessment and Stratification
In Guide to Health Risk Assessment and Stratification, 12 industry thought leaders describe the processes of health risk assessment (HRA) and stratification as well as applications and benefits of health assessment in the workplace and various healthcare settings. This 140-page guide also examines the HRA's impact on cost, utilization and patient health status. Contains more than 77 images; Q&A chapter answers more than 60 questions on health risk assessment.
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A Conversation With...
Kathy Brieger, RD, CDE, Hudson River HealthCare's (HRHC) chief operations officer, explained that HRHC takes a team approach to disease management in the 3,400 adult patients with diabetes it serves. Ms. Brieger describes the multiple levels of care available to patients served by the HRHC Diabetes Collaborative, a four-point strategy for weight management that targets the most challenging aspect of managing diabetes, and HRHC's upcoming trial of telepsychiatry at selected FQHCs.
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Healthcare Questions & Answers...
What Is The Role of The Patient Care Team in an ACO?This week's expert is Barbara Walters, DO, MBA, senior medical director with Dartmouth-Hitchcock.
Question: What are new rules and responsibilities for the patient care team in the ACO model?
Response: We do more proactive tasks in this model. For example, the nurses do outreach using the registry reports, like calling patients. The patients, especially in the Medicare population, have been absolutely delighted with this model of care. The nurses will call the patients and say, Mrs. Jones, we havent seen you in X amount of time. Its important at this time of year that you get a flu shot, and we believe that youre due for a mammogram. Why dont you come in? Calling, engaging and trying to activate patients is very different from an acute care-driven patient only making an appointment model.
Our patient data coordinators work behind the scenes helping us to sort and risk-stratify patients. Before, we were looking at the patients who were going to come in and thinking about them that day. Here, we are trying to look at our whole population of patients and say, We didnt realize that we had 18 patients who have this particular disease. Should we be doing something from a group perspective? Should we be doing some sort of outreach? Is there some new kind of treatment that we should be looking at for epilepsy? This is what happens when you start thinking about patients as a population rather than as individual patients.
For more information on health management tools for ACOs, please visit: http://store.hin.com/product.asp?itemid=4204
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