Designing the Care Management Infrastructure

See the results of our 2013 Population Health Survey

How are best-in-class population health managers deploying care management resources for high-, rising-, and low-risk patients? See how they're using medical homes, group visits, patient portals, and more.

Designing the Care Management Infrastructure

Results at a glance:

      • A majority of respondents deploy high-risk care managers who coordinate care for 200 patients or less
      • 57% of respondents will convert the majority of practices (75% or more) to the medical home model across the next three years
      • 45% of respondents are integrating behavioral health support in primary care
      • A majority of population health managers have a portal, but most report 25% or less of patients actively use it

Build the care management infrastructure

Best-in-class population health managers design the care management infrastructure around three distinct patient populations:

  • High-risk: The top 5% of the population with at least one complex illness, multiple comorbidities, and psychosocial needs
  • Rising-risk: The 15-35% of the population with multiple risk factors that could push them to the high-risk category if left unmanaged
  • Low-risk: The 60-80% of the population who are healthy today

The Care Transformation Center surveyed 180 health systems, standalone community hospitals, academic medical centers, and physician practices from July-October 2013 to offer a unique snapshot of how providers are deploying their care management resources.

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