New Arrows in the Quiver for Targeting Care Management
- 1 January 2007
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in The Journal of Ambulatory Care Management
- Vol. 30 (1), 39-51
- https://doi.org/10.1097/00004479-200701000-00007
Abstract
“Care management” purposefully obscures the distinctions between disease and case management and stresses their common features: action in the present to prevent adverse future outcomes and costs. It includes identifying a high-need population by referrals, screening, or data analysis, assessing those likely to benefit from interventions, intervening, evaluating the intervention, and adjusting interventions when needed. High-risk individuals can be identified using at least 9 techniques, from referrals and questionnaires to retrospective claims analysis and predictive models. Other than referrals, software based on the risk-adjustment methodology that we have adapted can incorporate all these methodologies. Because the risk adjustment employs extensive case mix and severity adjustment, it provides care managers with 3 innovative ways to identify not only high-risk individuals but also high-opportunity cases.Keywords
This publication has 13 references indexed in Scilit:
- Implementing a Predictive Modeling Program, Part 1Lippincott's Case Management, 2005
- The Importance of Medication Adherence in Improving Chronic-Disease Related OutcomesMedical Care, 2005
- Accuracy of Prediction Models in the Context of Disease ManagementDisease Management, 2005
- Development of the Patient Activation Measure (PAM): Conceptualizing and Measuring Activation in Patients and ConsumersHealth Services Research, 2004
- Estimating the Return on Investment in Disease Management Programs Using a Pre–Post AnalysisDisease Management, 2004
- Improving Primary Care for Patients With Chronic IllnessJAMA, 2002
- An Introduction to Predictive Modeling for Disease Management Risk StratificationDisease Management, 2002
- A Framework for Disease Management ROI Studies: A Health-Plan PerspectiveDisease Management, 2002
- Derivation of adherence metrics from electronic dosing recordsJournal of Clinical Epidemiology, 2001
- Case management programs in primary careJournal of General Internal Medicine, 1998