Insights on moderate risk cohort required for effective population health management
LOS ANGELES, March 26, 2014 /PRNewswire/ -- Population health management requires payers and providers to manage the healthcare utilization and costs of low, moderate and high-risk cohorts. To provide insight into the moderate risk cohort, DPS Heath, a provider of lifestyle and self-management interventions, and Humana Inc. (NYSE: HUM), have produced an issue brief on how to identify and manage moderate risk individuals.
The Moderate Risk Individual: Not Yet Sick Enough to be Very High Cost explains the need to address the moderate risk population and how to pinpoint and manage these individuals with early stage chronic disease and modifiable risk factors.
The DPS Health/Humana issue brief addresses a serious challenge. Moderate risk individuals, who are estimated to be as much as 35 percent of the population, consume healthcare at a rate of four to six times higher than averages seen among lower cost members, according to data from the Centers for Medicare and Medicaid (CMS). As a result, population health managers must zero in on the moderate risk cohort's modifiable risk factors, which include obesity and challenges with self-management, in order to impact conditions such as pre-diabetes/diabetes, sleep apnea, hypertension, metabolic syndrome and hyperlipidemia.
"Modifying the disease trajectories of individuals within the moderate risk cohort will reduce healthcare utilization and impact costs in the short-term," says Neal Kaufman, MD, MPH, founder and Chief Medical Officer, DPS Health. "Over the long-term, taking action against modifiable risk factors will lessen the chances that moderate risk individuals will become part of the costliest, sickest cohort."
The issue brief sites recent data and studies from Humana that define levels of utilization and cost within the moderate risk cohort, approaches to identifying these individuals, and challenges and opportunities in engaging and intervening.
"Humana recognizes the health impact to the millions of individuals in the moderate risk cohort, and this issue brief can help us all better understand this population and the opportunities to support them to modify risk factors like obesity and poor self-management," said Todd Prewitt, MD, Director Chronic Care Strategies, Health Guidance Organization, Humana. "Given the surge in chronic conditions and the aging of our population, payers and providers must tackle modifiable risk factors as quickly as possible or the situation will get worse before it gets better."
To download the issue brief, visit www.dpshealth.com/issuebrief.
About DPS Health
Founded in 2004, DPS Health enhances the capacity of organizations to improve the health of their members, employees or patients through research-proven, web and mobile self-management support interventions. For additional information, visit www.dpshealth.com.
Humana Inc., headquartered in Louisville, Ky., is a leading health care company that offers a wide range of insurance products and health and wellness services that incorporate an integrated approach to lifelong well-being. By leveraging the strengths of its core businesses, Humana believes it can better explore opportunities for existing and emerging adjacencies in health care that can further enhance wellness opportunities for the millions of people across the nation with whom the company has relationships.
More information regarding Humana is available to investors via the Investor Relations page of the company's web site at www.humana.com, including copies of:
- Annual reports to stockholders
- Securities and Exchange Commission filings
- Most recent investor conference presentations
- Quarterly earnings news releases
- Replays of most recent earnings release conference calls
- Calendar of events (including upcoming earnings conference call dates and times, as well as planned interaction with research analysts and institutional investors)
- Corporate Governance information
SOURCE DPS Health