Why is Risk Stratification Important?

As healthcare costs continue to rise, it’s imperative that the direct primary care (DPC) physician find effective ways to optimize the practice while continuing to provide quality care to patients. One technique that can help achieve that goal is risk stratification.

Risk stratification enables the DPC physician to essentially categorize patients based on their health status as well as other factors that could impact their care. The practice manages patients based on their assigned risk level so it can make better use of resources, anticipate the patient needs, and more proactively manage the patient population.

The technique uses a mix of objective and subjective data when assigning the risk level to patients in the practice. This enables the provider to make care management decisions, including providing greater access and resources, to those patients in higher risk levels. The practice is better able to focus on the patients with greater needs, even as it reduces costs and improves the level of care provided to all patients.

Stratification uses the patient’s risk status as a guide toward directing and improving care. The American Academy of Family Physicians (AAFP) states that the goal of risk stratification is to “help patients achieve the best health and quality of life possible by preventing chronic disease, stabilizing current chronic conditions, and preventing acceleration to higher-risk categories and higher associated costs.”

Providers can also determine how they will target patient engagement strategies as they understand more about patient needs, particularly which will require more attention. These strategies will lead to healthier patients who cost less to treat.

An independent physician can use risk stratification in patient engagement to determine which patients are at a higher risk of developing a costly condition, of costing the practice money, or of having a pre-existing condition become worse. The provider can use the process to better target patient engagement efforts, which have as their end goal providing the right intervention at the right time.

Healthcare efficiency can be better achieved by determining which patients should receive more extensive patient engagement efforts, as the provider will be more efficient about how their time and resources are used. The DPC provider can reduce costs by engaging their high-risk patients, as they keep those patients healthier and reduce any unnecessary or inappropriate healthcare utilization, including emergency department visits.

An electronic health record (EHR) system is an important piece of the risk stratification process. The provider can develop an effective risk model using the data available in the EHR, which contains the most comprehensive, accurate, and timely data for the practice’s patients. Data from other sources can also be used to fill in gaps in the available information. Using all the relevant data enables the independent practice to improve clinical outcomes and close care gaps, particularly for higher risk patients.

Elation’s Collaborative Health Record feature enables your practice to close the care gaps, ensuring that care is as efficient and effective as possible, through the timely sharing of patient information.

EHR data includes information from direct patient encounters, data from other healthcare providers such as specialty practices, laboratory data, and data connected with the social determinants of health for the patient population. Social determinants of health, which include socioeconomic factors in addition to physical environments and health behaviors, can be critical for understanding the total risk for patients. 

As healthcare costs continue to rise, it’s imperative that the direct primary care (DPC) physician find effective ways to optimize the practice while continuing to provide quality care to patients. One technique that can help achieve that goal is risk stratification.

Risk stratification enables the DPC physician to essentially categorize patients based on their health status as well as other factors that could impact their care. The practice manages patients based on their assigned risk level so it can make better use of resources, anticipate the patient needs, and more proactively manage the patient population.

The technique uses a mix of objective and subjective data when assigning the risk level to patients in the practice. This enables the provider to make care management decisions, including providing greater access and resources, to those patients in higher risk levels. The practice is better able to focus on the patients with greater needs, even as it reduces costs and improves the level of care provided to all patients.

Stratification uses the patient’s risk status as a guide toward directing and improving care. The American Academy of Family Physicians (AAFP) states that the goal of risk stratification is to “help patients achieve the best health and quality of life possible by preventing chronic disease, stabilizing current chronic conditions, and preventing acceleration to higher-risk categories and higher associated costs.”

Providers can also determine how they will target patient engagement strategies as they understand more about patient needs, particularly which will require more attention. These strategies will lead to healthier patients who cost less to treat.

An independent physician can use risk stratification in patient engagement to determine which patients are at a higher risk of developing a costly condition, of costing the practice money, or of having a pre-existing condition become worse. The provider can use the process to better target patient engagement efforts, which have as their end goal providing the right intervention at the right time.

Healthcare efficiency can be better achieved by determining which patients should receive more extensive patient engagement efforts, as the provider will be more efficient about how their time and resources are used. The DPC provider can reduce costs by engaging their high-risk patients, as they keep those patients healthier and reduce any unnecessary or inappropriate healthcare utilization, including emergency department visits.

An electronic health record (EHR) system is an important piece of the risk stratification process. The provider can develop an effective risk model using the data available in the EHR, which contains the most comprehensive, accurate, and timely data for the practice’s patients. Data from other sources can also be used to fill in gaps in the available information. Using all the relevant data enables the independent practice to improve clinical outcomes and close care gaps, particularly for higher risk patients.

Elation’s Collaborative Health Record feature enables your practice to close the care gaps, ensuring that care is as efficient and effective as possible, through the timely sharing of patient information.

EHR data includes information from direct patient encounters, data from other healthcare providers such as specialty practices, laboratory data, and data connected with the social determinants of health for the patient population. Social determinants of health, which include socioeconomic factors in addition to physical environments and health behaviors, can be critical for understanding the total risk for patients.