Adding a Measure of Self-Management Capability to Risk Assessment Can Improve Prediction of High Costs

Judith Hibbard
Jessica Greene
Rebecca M. Sacks
Valerie Overton
Carmen D. Parrotta
Journal Article
March 2016

This resource explores whether individuals’ levels of engagement in their care — referred to as “patient activation” — correlates with their use of services and status as “high need, high cost.” People who are less activated may benefit more than others from care coordination programs.

  • The resource explains the advantages of allocating resources based on individuals’ level of engagement, as measured by their activation scores.
  • Among persons at high risk of high health costs, the least activated individuals were significantly more likely to have an emergency department visit or hospitalization compared with the most activated.
  • Patient activation scores accurately predicted the use of costly services three years later.
  • Patient activation scores can help programs more effectively assess risk for high utilization, manage costs, and tailor outreach to individuals.

The Commonwealth Fund also published a short summary of this resource.

Posted to The Playbook on
Population Addressed
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Key Questions Answered
  • How does a person’s ability to self-manage (level of “activation”) inform predictive value of individuals identified as high risk for high health care spending?
  • What is the evidence about the relationship between activation levels and health care utilization?
  • Why is assessing activation level important for providers caring for individuals with complex needs?
Level of Evidence
What does this mean?