Tim Darling
The Next “Top 5%”: Identifying patients for additional care through micro-segmentation
Health data can go beyond the averages and first order patient characteristics to find long-term trends
This article was written with Arijit Sengupta, CEO of BeyondCore. Tim and Arijit will speak at Strata Rx 2013 on the topic of this post.
Current healthcare cost prevention efforts focus on the top 1% of highest risk patients. As care coordination efforts expand to a larger set of the patient population, the critical question is: If you’re a care manager, which patients should you offer additional care to at any given point in time? Our research shows that focusing on patients with the highest risk scores or highest current costs create suboptimal roadmaps. In this article we share an approach to predict patients whose costs are about to skyrocket, using a hypothesis-free micro-segmentation analysis. From there, working with physicians and care managers, we can formulate appropriate interventions.