One of the challenges in identifying patients with complex needs to enroll in an enhanced care program is that past health care utilization doesn't necessarily predict future utilization.
Successful programs develop and refine criteria to enroll patients for care management. At Partners HealthCare, the Integrated Care Management Program (iCMP) has used an evolving algorithm to identify patients, using claims data and information from the electronic medical record. The program also allows primary care providers to offer their insights as to which patients would most benefit from the program, taking into account the diversity of services available at various Partners sites.
The Better Care Playbook spoke with Christine Vogeli, PhD, Director of Evaluation and Research, Partners HealthCare Center for Population Health, to better understand the how the iCMP uses predictive analytics to identify patients to enroll. (To learn more about how the program is managed, please visit Part 2 of this interview.)
How does Partners HealthCare use predictive analytics in the iCMP?
What surprised you about the factors that predict high health care utilization?
What's the biggest challenge you've faced in using predictive analytics?
To learn much more, please visit the Playbook's key question, "Who are patients with complex needs?"
You may also be interested to read the following publications about the Partners iCMP program.