Integrating Psychosocial Risk Factors into Ongoing Care

    addressing the needs of rising-risk patients

    Health care delivery is incomplete without addressing patients’ psychosocial needs. Left unaddressed, these needs drive avoidable utilization and readmissions, and excess health care spending.

    To optimize outcomes and succeed under value-based reimbursement models, leading population health managers identify patients’ psychosocial risks and tailor care plan interventions accordingly.

    This research report makes the case for incorporating psychosocial needs into ongoing care, offers a blueprint for staff deployment across different interventions, and provides 18 case studies of providers that have successfully tailored interventions based on psychosocial needs.

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