Risk Stratification Care Management and More

The world of healthcare, while having made significant improvement over the past few years, still has a long way to go. In terms of managing patient care and trying to provide it in a more efficient manner, one of the key ways that it is often overlooked is through risk stratification care management. You may not have even heard about this type of care system and if not, it important to become educated so you know all of your options.

What is Risk Stratification
Care Management?

When you utilize the risk stratification care management method, you essentially assign a health risk to every patient. This health risk will directly relate to the care they receive and will ultimately improve their care as a result. Risk stratification care management is used to provide patients with the best quality of life possible as well as to help them obtain the best health. This method can be used in a variety of circumstances including with patients who have chronic diseases, stabilizing patients when they are not well or at risk, or even attempting to prevent an acceleration to a higher risk category. This method of patient care can help the patients better manage their needs while preventing them from getting worse due to not enough attention or care from providers.

How to Incorporate Risk
Stratification Care Management

Risk Stratification Care ManagementBefore you can implement a plan like this in your facility, you must first create a plan of action. To do this, the first step is outlining the risk categories for your facility or your patient types. Knowing the risk levels and what kind of care is associated with them is the first step. Then, once you have that in place, you can begin to start classifying your patients according to these categories.

With each patient, it is important that you identify their own personal health risk so you can then follow it up with developing their personalized care plan. The care team for the patient should work together so that everyone is on the same page in the process and knows what is expected of the care. The patient should also be involved with this process to ensure they are fine with the plan. Depending on the situation, other providers or physicians may need to be consulted. This will depend on the patient and their specific health condition.

Benefits of Risk Stratification
Care Management

Risk Stratification Care ManagementOn the surface, it is apparent that patients benefit substantially from this increased type of care. However, there are benefits to be enjoyed by the facility as well. The biggest benefit is the cost. On the surface, it may seem like it will be more expensive to provide additional care to patients. However, according to the Commonwealth Fund Issue Brief, 20 percent of the patient population already accounts for 80 percent of the total health care spending in the United States. Most of this is concentrated in the top 1 percent. This 20 percent, however, could greatly benefit from an increased level of support and by focusing efforts on maintaining their current risk or lowering it, instead of trying to catch it when it is too late, health care spending will actually go down. Additionally, as payment reform continues in the healthcare industry, many practices and facilities will likely begin using practices that categorize patients based on their level of care. This will allow for adjustments to be made for additional care through risk stratification care management so more resources can be given to the high-risk patients. This method is a way for both the patients to get the right level of care for their health category as well as for providers to be able to better focus their efforts and reduce spending.

Risk Stratification and
Precision Medicine

Risk Stratification Care Management

As a consequence of this scrutiny, and the furtherance of technology in the healthcare community, new and better ways to treat patient’s ailments have begun to surface.  Precision medical care isn’t necessarily something novel to the industry, precision medicine has been practiced for some time when it came to tissue or organ transplants or blood transfusions.  The closer the match, the better prognosis and less likelihood of complications arose. But, we have stepped into a new world where genes and genetics are now playing a huge role in healthcare treatments and preventative measures.

Instead of treating each patient like a cookie-cutter version of everyone else, a doctor can order a framework of genetic testing that can open the doors of understanding much further.  For example, a cancer patient with select gene characteristics has a better-projected outcome with certain treatments over others, which can help eliminate wasted time, energy and ineffective methods.  This is known because of the millions of people that have sought treatment and the information gathered about them over time. When comparing their data to people with similar physiology, healthcare professionals have seen comparable traits and reactions to drugs.  This bit of evidence plays a large part in who benefits from specific practices and who does not.