A chronic disease management program begins with identifying individuals with at-risk health conditions. Claims, biometric screening, and Health Risk Assessment data help identify an employee population’s risk levels: high, medium, and low.
As part of the initial stratification, an employer healthcare model should track how many individuals are outside the normal range and have progressed on key health status measures. The vendor you work with should also track how many individuals with chronic diseases are meeting the standard of care for their conditions. Marathon Health’s technology, for example, includes an integrated predictive modeling toolset provided at the individual and aggregate levels. We license the Johns Hopkins ACG models (https://www.hopkinsacg.org/) and leverage their predictive tools and our proprietary data models.
Individual risk scores are included in the personal health reports available to members on our online Patient Portal after they have completed a biometric screening and wellness assessment. We calculate a concurrent and prospective risk score on members for whom we have claims data to enhance our ability to support individuals with moderate-to-high-risk conditions.