Build three complementary care models

Insight 4 from the 2013 CEO Special Sessions

The population health managers that are getting it right are the ones that recognize that it’s not about one population. It’s about three—and each requires a different care model.


 

First, there are the high-risk patients, or those with at least one complex illness, multiple comorbidities, and psychosocial barriers. For these patients, you have two goals. Take an intensive, comprehensive, proactive approach to management and keep them out of high-cost, acute care services through low-cost care management when you can.

Then there are medium-risk (or rising-risk) patients, who have multiple chronic conditions. For this group, providers must avoid unnecessary spending and keep patients from becoming high-risk.


Last, there are low-risk patients, who are either healthy or have one well-managed chronic condition. For this population, just keep them healthy and loyal to the system when they need to be.