Effective Population Health
Effective Population Health
We are Not a Wellness Program
These programs focus on the motivated and generally healthy. Sick people have underlying manifest disease that cannot be overcome with the standard wellness program.
We Are Not a Disease Management Program
These programs attempt to stabilize and maintain a diseased state. The intention is to prevent it from becoming worse. However, the current strategy is symptom management, the individual's health is not improving in this process, but slipping into a downward spiral of diagnoses, medications and procedures to manage disease.
What We Are: Health Revival
Through our expertise in root-cause we are able to identify risks that may lead to disease and reverse these trends. Wellness 2.0
We understand mechanisms of disease thus are able to help people reverse their chronic conditions - not just manage symptoms. Disease Reversal 2.0
We specialize in Precise Predictive Analytics, Effective Root-Cause Prevention and Disease Reversal, and Accurate Population Stratification.
"Despite the myth of frequent fliers in high-cost health care, most of the top 5% of health care spenders were not in the top 5% the year before."
Healthcare Cost Institute
February 1, 2018
"The U.S. spends nearly twice as much in healthcare as other high income countries, yet has poorer population health outcomes."
Harvard T.H. Chan School of Public Health
March 13, 2018
Predictive Analytics
60%
Of health executives forecast that using predictive analytics will save their organization 15% or more over the next 5 years.
87%
Of executives say predictive analytics is important to the future of their business.
of providers
of payers
87%
83%
Either currently use predictive analytics or plan to do so in the next 5 years.
52%
Of executives say reducing costs is the most important outcome to achieve with predictive analytics
Society of Actuaries: 2018 Predictive Analytics in Healthcare Trend Forecast
Predictive Analytics
The Healthcare Cost Institute recently demonstrated that 61% of current very high cost claimants were actually low cost in previous years. The current methods of cost prediction, claims and wellness statistics, are proven inadequate in creating meaningful projections.
We use a 5-point algorithm that is both predictive and actionable. Many of the elements were developed by Harvard and MIT medical professionals and include: sophisticated risk assessment, advanced biomarker system panels and interpretation, analysis of pathology changes to tissue, scaling of active chronic disease, and traditional claims analysis. This robust approach enhances understanding of risk and disease potential based on a broader and deeper set of parameters than are currently used. Importantly, an output, in addition to the risk assessment, is action plans that entail assignment and allocation of appropriate resources: coaches, providers, and other resources.
At Kaiser Permanente 1% of our members account for 29% of our total healthcare cost, the concentration of spending at Kaiser is in line with national data, contributing to an increasing focus on improvement efforts for patients with complex needs."
NEJM Catalyst February 5, 2017
Root Cause Prevention and Disease Reversal
Root Cause Prevention and Disease Reversal
Chronic diseases drive 80% of medical visits and costs, yet the standard-of-care approach to chronic disease is “disease management.” We all know that disease management is actually symptom management. For example, a person with high blood pressure is placed on medication for fear that a vessel will burst – but nothing is done to improve the health of the vessel. This is disease management. The chronically ill, high cost and high risk people in your organization have nowhere to go except into the vortex of management. Do any of your providers have a program to remove people from prescription drugs? If not, the diseases of your population are being managed. And we are all informed that pharmaceuticals are rife with side effects.
Our medical and coaching team has a track record of treating the root-causes of chronic diseases while graduating our participants off unnecessary and harmful drugs. This program has two components:
1. Assessment of risk with our Chronic Disease Assessment™ protocol linked to intensive root-cause coaching to improve the overall health of the participant.
2. Oversight by a HRP (or HRP approved) provider to ensure medications are adjusted appropriately based on health status changes. The improved health of the patient is the determining factor for removing anyone from a medication – not an HRP decision. However, our team closely monitors the health status of our participants and ensures they are properly clinically assessed so they are never needlessly on a synthetic substance that is not providing benefit.
Population Stratification
Population Stratification
The sickest in any population may experience 100 times the healthcare costs compared to healthy individuals. Wellness programs tend to manage all equally even though there are tremendous disparities in health within any group. In 2018, 1% of a population drives a whopping 34% of costs and 10% drive 70% of costs. Also, 70% of a population costs just 10% of total healthcare spending yet these people make up the demographics of most wellness participants. When the health of people in this low-cost group improves, the ROI is minimal while the high cost and poor health group, if they participate, benefit very little from these “one-size-fits-all” programs.
The math is simple, high risk and chronically ill people drive substantial monthly costs justifying higher intensity efforts to improve their health. The ROI for someone costing >$5000/month is clearly superior to the ROI for someone costing $500/month. HRP uses methods to stratify populations that are similar to those described under “predictive analytics.” As an organization we specifically focus on high cost and high-risk individuals. We offer your organization an opportunity to realize the healthcare cost reduction you have worked hard to obtain with your wellness and cost reduction initiatives by focusing on the ±10 percent of your population that drives the majority of your costs.