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Health Risk Assessment and Stratification Set
Health Risk Assessment and Stratification Set
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A powerful component of a health planís disease management toolkit is the Health Risk Assessment (HRA), which evaluates the populationís health status and targets actionable programs to address identified risks. Implementing effective HRAs and mining the resulting data is a strategic means of harnessing healthcare costs and promoting consumer awareness.

In this 46-page special report, Mining Health Risk Assessments for Richer ROI and Results, HINís expert panelists explore the progressive evolution of HRAs. Gregg Lehman, PhD, former president and chief executive officer, Gordian Health Solutions, Marlene Sigwalt, RN, MSPH, clinical consultant, Innovation Center, Humana, Inc., and Yan Zhang, research scientist, Humana, Inc. provide procedures, objectives, predictive capacities, consumer engagement strategies and results of these tactical questionnaires to identify risk before it becomes reality.

Youíll also get case studies on the HRA programs at HealthAtoZ, Blue Shield of California and Aetna.

You'll get details on:

  • Evolutions in the HRA market;
  • Risk stratification in the HRA;
  • Ideas to incent HRA participation;
  • Strategies for engaging physicians in the HRA effort;
  • Case study of HRA implementation;
  • Anatomy of Humana's in-house HRA development effort;
  • Using HRAs to probe productivity;
  • How an incentives program at Blue Shield of California cut claims cost in its first year; and
  • Stratifying your population to identify next yearís high-risk population.

Table of Contents

  • HIN Survey Finds HRAs First Line of Defense in Population Health Management
  • Evolutions in the HRA Market
    • The Market Position
    • HRA Evolution
    • The Gordian HRA Model
    • Selective Branching Critical
    • Sample Online Questionnaire
    • HRAs as a Screening Tool
    • Risk Stratification in the HRA
    • Sample Health Risk Profile
    • Creating HRA Profiles
    • ROI in Population Health Management Strategies
    • DM Programs Yield Greatest ROI
    • Measuring Outcomes
    • The Human Condition
    • Lifestyle Incentive Programs
    • Ideas to Incent HRA Participation
    • Getting Physicians Involved
    • Healthcare Faces a Chronic Challenge
    • Chronic Care: The Burden of Illness
  • Same Time, Next Year: HRAs Help Rescue Risk Pool Drifters
    • Fine-Tuning the Message from the C-Suite
  • Getting What You Pay For: Cash Incentives Cut Claims Cost in First Year
    • Sample Questions from Blue Shield of California's HRA
    • Lessons Learned
  • On the Horizon: Using HRAs to Probe Productivity
    • Voluntary HRAs and Tempered Use of Incentives Is Best Strategy
  • Humanaís Home-Grown HRAs: Anatomy of In-House Development
    • Humanaís Health Management Strategy
    • HRA Application Architecture
    • HRA Process Flow
    • Sample HRA Results Screen
    • A Sample Population Rates the HRA
    • Going Forward
    • A Look at Satisfaction Ratings
  • Q&A: Ask the Experts
    • Dissecting the ROI
    • Keeping It Simple
    • Multiple Populations and the HRA
    • Determining Appropriate Interventions
    • Age-Related Concerns
    • Promoting Physician Engagement
    • Data Sharing and Application
    • The Movement to Standard Practice
    • Individual Impacts in PHM Analysis
    • The Role of Health Coaches
    • Member Qualification for Intervention
    • Match Case-Control Groups
  • Glossary
  • For More Information
  • About the Authors

To deflect the cost of chronic care, the scope of healthcare has broadened to embrace prevention. Using a variety of tools and methodologies, more healthcare organizations are striving to pinpoint that population poised for or in the midst of a health crisis and then attempting to slow or prevent complications. This special report, Health Risk Stratification: Targeted Tools and Methodologies to Prevent Illness and Improve Health, profiles the efforts of two organizations who have successfully identified high-risk members and patients and aligned appropriate interventions.

In separate case studies, Health Risk Stratification: Targeted Tools and Methodologies to Prevent Illness and Improve Health chronicles the paths of two healthcare organizations seeking to identify health risk factors in their respective populations and develop policies and outreach to put these individuals on the road to better health. With a special focus on the challenges of connecting with Medicaid enrollees, this 38-page special report highlights the essential role of the health risk assessment (HRA) tool in pinpointing the health status of employees and health plan members.

This 40-page report is based on contributions from Thomas Ferraro, business development director with Mayo Clinic Health Management Resources, and Penelope Kokkinides, national vice president of disease management with AmeriChoice, a United Healthcare Company, who presented at a HIN audio conference in August 2006.

PLUS this report contains a detailed analysis of the more than 200 responses to HIN's 2005 online survey on the use of HRAs by health plans, employers and healthcare providers.

You'll get details on:

  • Identifying health risk factors in populations and mapping risks to interventions;
  • The special challenges of engaging the Medicaid population;
  • Post-HRA interventions to promote health;
  • The incentive debate -- whether carrots or sticks motivate individuals to participate;
  • Collecting, analyzing, integrating and storing HRA data;
  • Interacting with HRA and disease management vendors;
  • The impact of HRAs on more than 200 healthcare organizations who use them -- employers, health plans and providers;
  • and much more.

Table of Contents

  • Strategies for Identifying and Referring the Appropriate Service and Intervention
    • Four Key Drivers of Participation
    • Matching Risk Factors to Interventions
    • The Role of Campaigns
    • The Coaching Continuum
  • Utilizing Health Risk Assessment Data to Target and Identify Members at High Risk for Chronic Disease
    • Additional Challenges of the Medicaid Population
    • The HRA Process at AmeriChoice
    • Time Constraints and Frequency of HRAs
    • Internal HRAs Yield the Best Results
    • Identifying Unnecessary Emergency Room Utilization
    • The HRA Engagement Process
    • Targeting, Stratifying and Referring Members
    • Vendor Interactions
    • Key Program Factors
  • HIN Online Survey Results: How the Healthcare Industry Identifies Risk Before It Becomes Reality
    • A Tool for All Trades
    • Incentives Boost Participation
    • Mining Data for ROI
    • Lessons Learned
    • Moving Forward
  • Q&A: Ask the Experts
    • Storage Formats for HRA Data
    • Analyzing Higher Response Rates for Home-Grown HRAs
    • Coach Contact Frequency and Caseloads
    • Integrating HRAs with Other Data
    • Optimal Length for an HRA Questionnaire
    • The Effect of the Medium on the HRA
    • Reducing Inappropriate ER Utilization
    • Acquiring NCQA Certification
    • Carrots or Sticks: Incentives That Get Results
  • Glossary
  • For More Information
  • About the Authors
Publication Date: October 2006
Number of Pages: 86
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