As mentioned in previous posts, and in our new white paper, Population Health Management 2.0, the key to population health management is working with patients of all risk levels, not just medium and high-risk patients.
Data from Dr. Dee Edington and the University of Michigan Health Management Research Center tells us that when workers move out of the medium- and high health-risk categories, others are already moving in. Employers need programs that prevent the upward flow from low-risk to medium- and high-risk. “Not getting worse” is imperative in containing costs.
This begs the obvious question.
How do you identify risk?
We’ve found the best way to identify risk is by analyzing claims, biometric screening, and Health History and Risk Assessment data. Using all three data sets, clinical staff are able to develop a composite of each employee’s health status and establish a specific care model. Here are recommendations for collecting the data:
This is fairly self-explanatory. We recommend requesting 12 months of historical medical claims data from your carrier, and then an ongoing feed of medical claims on a monthly basis. It’s important to make sure the claims are shared in an agreed-upon standard format to account for any discrepancies.
Biometric screening options include finger sticks and venipuncture. Standard biometric screening services include blood pressure, weight, BMI, body fat percentage, full lipid panel, and fasting glucose levels. We recommend holding an annual mass biometric screening event in a compressed timeframe in order to minimize disruptions to the daily operations of the onsite health center, if applicable, and to provide the fastest transmission of biometric screening data for outreach purposes. There are several third-party providers available to conduct biometric screenings onsite for employers.
Health History and Risk Assessment
There are numerous HRAs available both online and in hard copy. We recommend an online version that matches patient information with an extensive medical database to provide guidance tailored to the patient. Information collected in an HHRA includes a patient’s current symptoms and conditions, mental health and emotional wellbeing, personal self-care, immunizations, allergies, medications, surgeries and tests, and health history. We recommend that employees complete the HHRA annually but this may vary depending on organizational health incentives and goals for risk factor measurement.
Once risks are identified using these three methods, the next step is stratifying the entire population into three risk levels – high, medium, and low – so you can track how many individuals outside normal range have made progress on key health measures such as blood pressure, lipids, body-mass index, blood sugar, tobacco and alcohol use, and stress. You’ll also able to measure how many individuals with chronic disease are at the standard of care for their conditions (e.g. diabetes, asthma, heart disease, COPD).
With this information gathered, employers can change the risk profile of their populations through primary care, health coaching and condition management onsite. Undiagnosed conditions are discovered and treated, and specialist visits and hospital admissions are reduced, resulting in lower medical claims, fewer work loss days, and higher productivity.