Managing the Risk of a Population

As healthcare providers assume risk for the cost and quality of their patients' care, they need tools to understand and manage that risk. You can't manage what you can't measure.

Any network taking on risk-based contracts must be able to:

  • Evaluate the level of risk in patient populations
  • Measure and improve the quality of care across the entire network
  • Provide credible data to physicians to influence care decisions
  • Increase cost efficiencies through methods such as generic utilization and adherence to prescribing guidelines
  • Influence physician and patient behavior with timely and clear communications
  • Track clinical measures and calculate physician pay-for-performance (P4P) incentives
  • Manage multiple payers' data and adjudicate the measures specific to each payer

Profitable risk management in healthcare requires the network to be forward thinking in its approach to patient care. The network should:

  • Segment populations through predictive analytics in order to forecast future costs of care for each population
  • Predict likelihood of hospitalization and take steps to prevent readmissions
  • Identify and manage high-risk patients through the use of evidence-based care plans
  • Manage cost, utilization, and physician efficiency throughout the entire network

Learn how McKesson Risk Manager can help provider networks achieve operational efficiencies and measurable cost and quality of care improvements.

Next: Optimize network performance