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How Texas Health Resources is creating 'a science out of well-being'

Yulan Egan

Jonathan Scholl became Texas Health Resource’s (THR) first chief strategy officer in 2010. As the CSO and executive vice president, he is responsible for THR’s strategic planning and business development functions. Previously, Mr. Scholl spent 14 years at The Boston Consulting Group, where he was a partner and managing director.

We recently sat down with Mr. Scholl to understand how THR successfully promotes well-being through risk stratification.



How are you approaching population health management at THR?

Mr. Scholl: As a system, we’ve expanded our definition of what success means. In ten years, we want to be managing the health of a third of the population in our area. This doesn’t necessarily mean that all of these patients will be coming in for visits. Managing them could involve telephonic or web-based interventions. But our goal is for these patients to actively view THR as being "their network."

Today, we have some attributed lives and are trying to grow our network. So we’re running risk models and stratifying our population. And then we are generating care gap reports and pushing those out into the physician workflow.



What does your risk stratification system look like?

Mr. Scholl: The key here is that we’re not only focusing on the high-risk, high-cost patients. They are important to manage, as we all know. But, we’re also targeting low-risk and medium-risk patients who will become high-risk over time if we don’t do something for them.

  • Learn why each patient type requires a different care management approach.

We think about patients in terms of a few groups. There’s a group that exhibits no medical risk factors—these are our healthy patients. Then we have another group which has emerging risk factors—things that you can pick up in medical screenings and range from low to higher severity. Next there’s a population that is having a care episode—so patients who are in the hospital or who have an acute care need. And then there’s a group that has chronic disease and needs ongoing management.

We recently entered into a 10-year partnership with a well-being solutions company called Healthways, and we’re working with them to develop this risk stratification system.



Can you tell us more about how the partnership with Healthways has informed THR’s risk stratification system?

Mr. Scholl: Healthways has developed a comprehensive well-being assessment, which we think is crucial for population health. THR believes that health is not just the absence of disease or infirmity. It’s a state of well-being that encompasses how you feel about your personal life, your work life, your emotional health, your social networks, and your physical health.

So imagine an HRA that isn’t just about physical health. Gallup and Healthways have developed this—a well-being assessment that encompasses the full definition of health.

And if you take this well-being assessment and combine it with traditional biometric data, you can start to get predictive about populations. That’s what we’re trying to do at THR.



How else are you working with Healthways to promote well-being in your population?

Mr. Scholl: Another Healthways product we’re experimenting with is MeYou Health, a health gamification company. There are a few components of this.

First, people can subscribe to a daily health challenge. They can complete the challenge and interact with their social network about what they did and how they did it. Second, MeYou Health actually asks users to assess and report their well-being. So Healthways can look at whether or not someone has completed their daily challenge and see how it correlates with overall well-being.

Finally, these challenges can be tailored at the individual level. So if you know that someone has unhealthy eating behaviors, you can push out challenges related to grocery shopping habits—purchasing more whole grains, for example.  

Ultimately, we’re looking to create a science out of well-being.

More On Risk Stratification

The appendix in our study, High-Risk Care Management, contains a chart that compares care management programs at Partners HealthCare/Massachusetts General Hospital and Iora Health, including each organization's risk stratification methodology.

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And while you're here, be sure to check out two of our most popular posts: our take on the annual physical and how the answer to one simple question could be a more accurate predictor of health care utilization than any IT system.

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