Efficiently Measuring Health Care Risk

Measuring health care risk is a cornerstone of the Accountable Care Organization (ACO) model and of modern health care generally.  Citing a report by Chilmark Research, Clinical-Innovation.com recently wrote that ” ..to succeed in a value-based model, healthcare organizations require tools to leverage clinical, claims and demographic data to improve care delivery and manage population risk.”

Predicting risk is often difficult for at least three reasons.  First, you need the data to build an overall prediction model and you need data from an individual patient to run that model.  Second, you need a model that works for the outcome(s) of concern.  Third, you need to be able to easily run that model in your business operations.

It follows that the best possible model combines the lowest cost of data acquisition both for model building and model running; that the data when run through the model will provide a good prediction;  and that the generated prediction will be usable in managing health care populations.

Objective Arts has partnered with a group of economists who have studied prediction with these factors front and center.  They will soon publish a paper in Health Services Research outlining  a model that will satisfy requirements one and two above.   Perhaps the biggest problem in predicting health care risk is assembling a very unwieldy mass of claims data to build models and then run them for individual patients.  These authors have shown that you can eliminate this problem altogether and still do a relatively good job at prediction.  It turns out that self-reports are surprisingly good at predicting future health care risk as long as you know what to ask. The paper describes the statistics that went into deciding what to ask and determining the numerical impact each item has on the overall risk prediction.

Objective Arts provides the necessary software automation for an organization to easily integrate predictions into business flows.  We enable easy use of the model through Web Services or a lightweight user interface.  We also give an organization the ability to fire alerts and send messages based on a calculated risk level.  We provide  autogenerated reports and graphical widgets that give the manager and the practitioner easy insight.

If you would like to try the model out, please contact us at info@objectivearts.com.  We would be happy to show you how it works in real time.

Leave a Reply

Your email address will not be published. Required fields are marked *