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The Quest for
Better Health Outcomes While health plans are preparing for change in today’s dynamic healthcare environment, the "Triple Aim" to achieve better health outcomes and an improved experience of care while controlling costs will be a constant, underlying goal shaping strategies and operations. In this quest, measures of quality will continue to play a key role in driving member health and physician performance. The Healthcare Effectiveness Data and Information Set (HEDIS®) is a collection of standardized performance measures designed to ensure that purchasers and consumers have the information they need to reliably compare healthcare quality. HEDIS is widely used by health plans, physicians, and other organizations to evaluate and report healthcare performance on multiple dimensions of care and service. Performing well on HEDIS measurement and your broader population health goals requires a combination of deep industry experience, technologies, regulatory insight, and a wide range of data and analytics that support predictive modeling. "HEDIS in 2018: The Quest for Better Health Outcomes" describes the best practices many plans are adopting for this critical business process. |
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"Identifying at-risk
populations based on social determinants of health and then
tailoring healthcare delivery to them is a cornerstone of
population health management... By identifying socioeconomic
factors, such as education level or economic stability, and
combining it with predictive modeling, healthcare organizations
can acquire more expansive views of consumers at risk for
avoidable healthcare costs – improving risk prediction to better
support early interventions." -Manu Varma, Business Leader, Philips Wellcentive and Hospital to Home. |
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"The researchers found
that 'using data available within the first 30 minutes after
presentation, the model identified 73.4% of the hospitalizations
with 90% specificity and 35.4% with 99.5% specificity.'" Excerpted from: Predictive Modeling News, Volume 10 Number 8, August 2017, "Journal Scan: Pediatrics: 'Early Prediction Model of Patient Hospitalization from the Pediatric Emergency Department.'" |
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Care Management - Critical Component Of Effective Population
Health
Dr. Kathleen Clary shares how analytics can be used to ensure
delivery of a well-organized and effective care management
program. She discusses how analytics can enable: (1) Data
integration from multiple EMRs and data sources; (2) Patient
stratification and intake; (3) Care coordination; (4) Patient
engagement; (5) Performance measurement. |
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- Journal Scan: Hopkins, HealthPartners Research Sees Predictive Value in EHR-Only Data
- Health Leader College's Infographic Details Hospital Use of Predictive Analytics
- Movers & Shakers: Excel Medical; Clarify Health; InteliSys Health; ZeOmega; and EagleForce Health
- GenRe Sees PA Understanding Gaps in Insurer Survey
- Thought Leaders' Corner: "How can predictive analytics best be used to support screening and care interventions based on social determinants of health?"
- Industry News with briefs regarding: Intermedix and SourceLink
- Predictably Quotable
- Click here to view page one of this issue
- Click here to subscribe to Predictive Modeling News, or find out more
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