Current Applications of Risk Identification and Stratification in Provider-led Care Management

A Shift in Responsibility

What has changed in the last 2 or 3 years is that now providers are undertaking their own provider-led care management initiatives and are also beginning to comb through their patients’ data, increasingly using clinical data for risk identification and stratification for several purposes including: possible enrollment in a care management program, identification of the proper resource intensity for a patient (e.g., health coach vs a nurse care manager), discharged patients who may need additional support, etc.

As a part of the upcoming Care Management and Care Coordination study that Chilmark Research is undertaking this summer, we will provide more clarity as to how vendors are utilizing risk identification and stratification in their solutions to optimize care processes. This will include such issues as:

• Where and how this data is being presented in their solutions to users,
• What types of external methodologies they might be employing, and
• Insights into the proprietary methodologies that vendors are utilizing.

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