The case management assessment is the top tool for stratifying candidates for telephonic case management contact, according to market data from HIN’s 2014 survey on Telephonic Case Management.
Sixty-one percent of respondents use a case management assessment to identify high-risk, high-cost individuals who would benefit from telephonic follow-up and care coordination.
Other risk stratification tools reported by survey respondents include the following:
- Provider referral: 60 percent
- Claims utilization data: 55 percent
- Hospital census and discharge reports: 48 percent
- Predictive modeling: 39 percent
- Self- or family referrals: 37 percent
In other market data, more than 84 percent of respondents utilize telephonic case managers, with more than half—54 percent—making contact with patients from virtual home offices.
The complex comorbid are the primary targets of telephonic case managers (TCMs), the survey found, but the newly discharged, those in acute stages of chronic illness, frequent utilizers and high-risk, high-cost patients also receive their fair share of telephonic attention from these case managers.
Stratifying High-Risk, High-Cost Patients: Benchmarks, Predictive Algorithms and Data Analytics presents a range of risk stratification practices to determine candidates for health coaching, case management, home visits, remote monitoring and other initiatives designed to engage individuals with chronic illness, improve health outcomes and reduce healthcare spend.
Each program discussion is supplemented by market data on risk stratification approaches for that care coordination intervention.