Health Risk Stratification : Targeted Tools and Methodologies to Prevent Illness and Improve Health

To deflect the cost of chronic care, the scope of healthcare has broadened to embrace prevention. Using a variety of tools and methodologies, more healthcare organizations are striving to pinpoint that population poised for or in the midst of a health crisis and then attempting to slow or prevent complications. This special report, Health Risk Stratification: Targeted Tools and Methodologies to Prevent Illness and Improve Health, profiles the efforts of two organizations who have successfully identified high-risk members and patients and aligned appropriate interventions.In separate case studies, Health Risk Stratification: Targeted Tools and Methodologies to Prevent Illness and Improve Health chronicles the paths of two healthcare organizations seeking to identify health risk factors in their respective populations and develop policies and outreach to put these individuals on the road to better health. With a special focus on the challenges of connecting with Medicaid enrollees, this 38-page special report highlights the essential role of the health risk assessment (HRA) tool in pinpointing the health status of employees and health plan members.This 40-page report is based on contributions from Thomas Ferraro, business development director with Mayo Clinic Health Management Resources, and Penelope Kokkinides, national vice president of disease management with AmeriChoice, a United Healthcare Company, who presented at a HIN audio conference in August 2006.PLUS this report contains a detailed analysis of the more than 200 responses to HIN's 2005 online survey on the use of HRAs by health plans, employers and healthcare providers.You'll get details on: * Identifying health risk factors in populations and mapping risks to interventions; * The special challenges of engaging the Medicaid population; * Post-HRA interventions to promote health; * The incentive debate -- whether carrots or sticks motivate individuals to participate; * Collecting, analyzing, integrating and storing HRA data; * Interacting with HRA and disease management vendors; * The impact of HRAs on more than 200 healthcare organizations who use them -- employers, health plans and providers; * and much more. Table of Contents * Strategies for Identifying and Referring the Appropriate Service and Intervention o Four Key Drivers of Participation o Matching Risk Factors to Interventions o The Role of Campaigns o The Coaching Continuum * Utilizing Health Risk Assessment Data to Target and Identify Members at High Risk for Chronic Disease o Additional Challenges of the Medicaid Population o The HRA Process at AmeriChoice o Time Constraints and Frequency of HRAs o Internal HRAs Yield the Best Results o Identifying Unnecessary Emergency Room Utilization o The HRA Engagement Process o Targeting, Stratifying and Referring Members o Vendor Interactions o Key Program Factors * HIN Online Survey Results: How the Healthcare Industry Identifies Risk Before It Becomes Reality o A Tool for All Trades o Incentives Boost Participation o Mining Data for ROI o Lessons Learned o Moving Forward * Q&A: Ask the Experts o Storage Formats for HRA Data o Analyzing Higher Response Rates for Home-Grown HRAs o Coach Contact Frequency and Caseloads o Integrating HRAs with Other Data o Optimal Length for an HRA Questionnaire o The Effect of the Medium on the HRA o Reducing Inappropriate ER Utilization o Acquiring NCQA Certification o Carrots or Sticks: Incentives That Get Results * Glossary * For More Information * About the AuthorsFerraro, Thomas is the author of 'Health Risk Stratification : Targeted Tools and Methodologies to Prevent Illness and Improve Health', published 2006 under ISBN 9781933402666 and ISBN 1933402660.