Manage rising-risk patients in the medical home

Insight 7 from the 2013 CEO Special Sessions

Today’s chronically ill are tomorrow’s high-cost patients.

To identify this "rising-risk" population, target the risk factors that underlie multiple chronic diseases, rather than the disease states themselves. Once you identify patients who have these risk factors, connect them to the medical home.

This team-based approach to care offers the perfect balance between customized support and the scale necessary to manage this population with limited resources.