For most ACOs, hospitals, and health plans, the top 5% of patients are considered high-risk and responsible for >50% of total health care spend. This cohort of patients often includes those with severe and significant multiple chronic conditions. These patients can also have rapidly escalating care needs and end up in high-cost care settings. Due to claims data lag, it can be 30-90 days before care management teams are aware of an acute care event, which impacts health outcomes for patients and increase costs for organizations. Further complicating the matter, this population has a turnover rate of 80% year-over-year, which complicates the ability to identify, track, and manage these patients.
Rising Risk is an innovative care management feature in our Pings solution that not only identifies and alerts care managers of high- and rising-risk patients in real time, but also provides a post-discharge follow-up workflow to assist with managing those prioritized patients.