Status One Breakthroughs in High Risk Population Health Management

by Forman, Samuel; Kelliher, Matthew

• ISBN13: 9780787941543
• ISBN10: 0787941549
• Edition: 1st
• Format: Hardcover
• Copyright: 1999-07-19
• Publisher: Jossey-Bass

Summary

A Proactive Framework for Organizational Change Learn to apply the principles of total quality management to the management of high-risk patients and improve quality of care, patient outcomes-and the bottom line. "Finally, a model of managed health care that resonates with physicians and patients. A new direction for care management that makes sense on both humanitarian and financial grounds."--Sanford T. Kurtz, M.D., vice president and chief medical officer, Lahey Clinic "An exciting, promising, practical, and brand new approach to solving the cost/quality dilemma in managed care--high-risk population health management. This well thought-out program focuses on managing patients, not physicians."--Stuart Baker, M.D., executive vice president of clinical affairs, Voluntary Hospital Association

Author Biography

SAMUEL FORMAN, M.D., is chief medical officer of StatusOne Health Systems (www.statusone.com). He is an acknowledged authority on population health management, disease management, and outcomes studies. MATTHEW KELLIHER is president and chief executive officer of StatusOne Health Systems. A leading innovator in the health care field, Kelliher has more than twenty years experience with improving health care systems throughout the United States.

Table of Contents

Preface	ix
Acknowledgments	xiii
The Authors	xvii
Part One: Overview
High-Risk Population Health Management	3	(14)
Part Two: Components
Segmenting the Population	17	(12)
Information: The Right Kind, in the Right Place, in Time	29	(24)
Structure: Building a Supportive Environment	53	(14)
Assessing the Patient: Getting to the Heart of the Matter	67	(12)
Formulating Care Plans: To Each According to their Needs	79	(18)
Renewals and Endings: Reassessment and Discharge	97	(8)
Gauges on the Dashboard Process and Outcome Measures	105	(10)
Part Three: Alternate Approaches to Medical Management
Theory of the Case: Varied Ways to Identify High-Risk People	115	(12)
Intervening on Behalf of the Severely Afflicted: Case Management	127	(12)
Intervening by Clinical Condition: Disease Management	139	(12)
Agenda for the Future	151	(8)
Part Four: Sources and Rationale
Total Quality Management: Concepts, High-Risk Patient Customers, Measures, and Focus	159	(16)
Epidemiology: Power and Limits of Statistical Approaches	175	(18)
Economics: Structural Aspects and Costs in Managed Health Care Populations	193	(16)
Part Five: Putting It Together
Summary: Best Practices in High-Risk Population Management	209	(4)
References	213	(8)
Exhibits	221	(10)
Index	231