this handy Care Continuum Alliance resource titled "Population Health Management: A Road Map for Primary Care Practices."
Thanks to this well written, extensively referenced and evidence-based report, primary care leaders can learn how to align population health management (PHM) with their primary care physician network to reduce risk, maximize savings, achieve efficiencies and minimize any disruption of their physicians' work flows. The rest of the world may be going to hell in a hand basket, but docs will be far better positioned to bend the cost curve and be rewarded with that fat end-of-year reconciliation check.
The report discusses:
1) how health risk assessments (HRAs) can be used to gauge the risk of those patients you don't know about;
2) the role of predictive modeling in stratifying the risk of your attributed population;
3) how to recruit and engage patients at greatest risk
4) how clinical guidelines can be best applied at the point of care
5) why care managers can assume responsibility for identifying and recruiting at risk patients and advocating on behalf of the guidelines.
How can the Disease Management Care Blog be so confident that this report is all that and more? It helped write it.
And the best part is that the document download is for free.