Nav: Home

Primary care practices use 4 complementary methods to identify high-risk patients

September 12, 2017

Risk stratified care management--assigning a patient to a risk category on which care is based--is increasingly viewed as a way to improve care and reduce costs. An analysis of 484 practices in the Comprehensive Primary Care initiative finds that practices used four primary methods to risk stratify their patient populations: a practice-developed algorithm (215 practices), an American Academy of Family Physicians clinical algorithm (155 practices), payer claims/electronic health record (62 practices), and clinical intuition (52 practices). Practices that developed their own algorithm identified more patients in the highest two risk tiers (mean=286 patients) than practices that used the AAFP algorithm (mean=181 patients), claims/electronic health record-derived algorithm (mean=171 patients), or clinical intuition (mean=218 patients). However, practices using a practice-developed algorithm had statistically significant lower numbers of patients receiving care management (69 patients) when compared to clinical intuition (91 patients). Of note, practices that primarily used clinical intuition provided care management to the highest proportion of high-risk patients. The authors suggest that, as payers shift reimbursement from volume-based to value-driven care, more primary care practices will focus on finding the best ways to implement high-risk care management.

-end-

Risk Stratification Methods and Provision of Care Management Services in Comprehensive Primary Care Initiative Practices
Ashok Reddy MD MS, et al
University of Washington School of Medicine, Seattle, Washington

http://www.annfammed.org/content/15/5/451.full

American Academy of Family Physicians

Related Care Articles:

Care management program reduced health care costs in Partners Pioneer ACO
Pesearchers at Partners HealthCare published a study showing that Partners Pioneer ACO not only reduces spending growth, but does this by reducing avoidable hospitalizations for patients with elevated but modifiable risks.
Emergency care, prescribing, end-of-life care among highlights at #AGS17
Potentially inappropriate medications, the future of Advance Care Planning (ACP), and improved emergency care for older adults are among headline presentations anchoring the American Geriatrics Society (AGS) 2017 Annual Scientific Meeting (#AGS17), to be held May 18-20 in San Antonio, Texas.
Palliative care consults for advanced cancer patients reduces hospitalization and improves care
Cancer patients admitted to the hospital with advanced stages of disease who were referred early to palliative care had decreased health care utilization and increased use of support services following discharge, according to a new study led by researchers at the Icahn School of Medicine at Mount Sinai.
Affordable Care Act boosted primary care access for Medicaid patients
Since the introduction of the Affordable Care Act, which provided access to health insurance to millions of previously uninsured adults in the United States, the availability of appointments with primary care physicians has improved for patients with Medicaid and remains unchanged for patients with private coverage, according to new research.
Most primary care doctors 'strongly endorse' key elements of the Affordable Care Act
Proponents of repealing the Affordable Care Act, including President Donald Trump's nominee for Secretary of Health and Human Services, Tom Price, have argued that the law places an undue burden on physicians.
Primary care physician involvement at end of life associated with less costly, less intensive care
A new study published in the January/February issue of Annals of Family Medicine finds that primary care physician involvement at the end of life is associated with less costly and less intensive end-of-life care.
Advocacy and community health care models complement research and clinical care
Global lung cancer researchers and patient advocates today emphasized that new models of delivering care and communicating about cancer care play an important role in the fight against lung cancer.
Patients not attached to new primary care practices receive lower quality care
One in six patients in Ontario does not belong to an organized primary care practice, new research suggests.
In India, training informal health-care providers improved quality of care
Training informal health-care providers in India improved the quality of health care they offered to patients in rural regions, a new study reports.
Affordable Care Act has improved access to health care, but disparities persist
The Affordable Care Act has substantially decreased the number of uninsured Americans and improved access to health care, though insurance affordability and disparities by geography, race/ethnicity, and income persist.

Best Science Podcasts 2017

We have hand picked the best science podcasts for 2017. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: Radiolab

Oliver Sipple
One morning, Oliver Sipple went out for a walk. A couple hours later, to his own surprise, he saved the life of the President of the United States. But in the days that followed, Sipple's split-second act of heroism turned into a rationale for making his personal life into political opportunity. What happens next makes us wonder what a moment, or a movement, or a whole society can demand of one person. And how much is too much?
Now Playing: TED Radio Hour

Future Consequences
From data collection to gene editing to AI, what we once considered science fiction is now becoming reality. This hour, TED speakers explore the future consequences of our present actions. Guests include designer Anab Jain, futurist Juan Enriquez, biologist Paul Knoepfler, and neuroscientist and philosopher Sam Harris.