Using “Activation” Scores to Predict Use of High-Cost Care

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Health systems usually rely on past medical claims and diagnosis data to identify those patients most likely to be high users of costly health care services. But a team of Commonwealth Fund–supported researchers believes there’s a crucial element missing from this calculus: patients’ “activation” level.<br /><br />
In a new <em></em><a href="/publications/journal-article/2016/mar/adding-measure-patient-self-management-capability-risk"><em>Health Affairs</em> article</a>, the University of Oregon’s Judith H. Hibbard and colleagues report that patients with the knowledge, skills, and confidence needed to manage their health conditions—those who are activated—are significantly less likely to visit an emergency department or be admitted to the hospital. Moreover, activation scores can be used to accurately predict a patient’s future use of health services. This information, the authors say, can help health systems better assess risk, manage costs, and address patients’ needs.<br />
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Also in the new <em>Health Affairs</em>, Commonwealth Fund–supported researchers led by Dartmouth’s Carrie H. Colla compare accountable care organizations (ACOs) that include hospitals in their networks with those that do not. The <a href="/publications/journal-article/2016/mar/hospitals-participating-accountable-care-organizations-tend">team’s findings</a> show that while the inclusion of hospitals does not appear to affect an ACO’s capacity to manage hospital-related aspects of patient care, it does allow the ACO to offer a more comprehensive array of patient services. Hospitals also provide an important source of capital for funding quality-reporting efforts, the researcher say.<br />
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