Opportunity to Enhance the Use of Health Risk Assessments
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To succeed in this era of health system transformation, plans and providers bearing risk – in an accountable care organization (ACO) for example – will need strategies for managing a broad array of care needs for high-risk beneficiaries across multiple settings of care. Download this fact sheet to learn more.
Date Updated: 09/01/2014
A perfect storm of events is driving payers and providers to better manage the cost of their high-risk Medicare beneficiary population—dramatic changes in Medicare payment policy, growth in Medicare Advantage (MA) plan enrollment, and the aging population will make it impossible to avoid increasing financial risk. To succeed in this era of health system transformation, plans and providers bearing risk – in an accountable care organization (ACO) for example – will need strategies for managing a broad array of care needs for high-risk beneficiaries across multiple settings of care. One data collection tool that offers a particularly strong opportunity to improve identification of high-risk members is the health risk assessment (HRA).
HRAs are able to identify health behaviors and risk factors that would not be picked up in claims data, generating a more complete picture of the member.
To evaluate the state of HRAs used by payers, Avalere Health reviewed government regulations and relevant literature, and conducted interviews with HRA experts to understand common HRA practices, potential shortcomings, and recommendations for improvements…