UNDERSTANDING HEALTH RISK

Populations vary dramatically in their risk for future cost and their need for medical services. Health risk may be examined at a population (employer group or plan) level or it may be examined at the individual patient level. Understanding risk at the population level is important for plan design, re-insurance, networks, reimbursements, and quantification of other population level concerns. Understanding risk at the patient level allows development of focused interventions and quantifies the impact on individuals in the population.

Many factors contribute to future risk including:

Case Mix

Illness Burden

Demographics

Access to Care

The single greatest predictor of individual future risk of high utilization is co-morbidity. Patient-centric measures and metrics tend to deliver the most actionable information both at the individual patient level and when aggregated to population level concerns.

EmmData has developed and customized tool sets, processes, and services that address risk at both the individual patient level and also at the population level.