Status One

A Proactive Framework for Organizational Change

Learn to apply the principles of total quality management to themanagement of high-risk patients and improve quality of care,patient outcomes-and the bottom line.

"Finally, a model of managed health care that resonates withphysicians and patients. A new direction for care management thatmakes sense on both humanitarian and financial grounds."--SanfordT. Kurtz, M.D., vice president and chief medical officer, LaheyClinic

"An exciting, promising, practical, and brand new approach tosolving the cost/quality dilemma in managed care--high-riskpopulation health management. This well thought-out program focuseson managing patients, not physicians."--Stuart Baker, M.D.,executive vice president of clinical affairs, Voluntary HospitalAssociation Overview.

1. High-Risk Population Health ManagementComponents.

2. Segmenting the Population.

3. Information: The Right Kind, in the Right Place, in Time.

4. Structure: Building a Supportive Environment.

5. Assessing the Patient: Getting to the Heart of the Matter.

6. Formulating Care Plans: To Each According to Their Needs.

7. Renewals and Endings: Reassessment and Discharge.

8. Gauges on the Dashboard: Process and Outcome Measures.

Alternate Approaches to Medical Management.

9. Theory of the Case: Varied Ways to Identify High-RiskPeople.

10. Intervening on Behalf of the Severely Afflicted: CaseManagement.

11. Intervening by Clinical Condition: Disease Management.

12. AgAnda for the Future.

Sources and Rationale13. Total Quality Management: Concepts,High-Risk Patient Customers, Measures and Focus.

14. Epidemiology: Power and Limits of Statistical Approaches.

15. Economics: Structural Aspects and Costs in Managed CarePopulations.

Putting it Together16. Summary: Best Practices in High-RiskPopulation Management.

References.

Exhibits.

Index. "Forman and Kelliher present a compelling, field-tested approach tohealth care delivery and a new direction for case management thatmakes sense on humanitarian and financial grounds." --Kate JennisonGoonan, vicepresident, clinical performance improvement, UMassMemorial Health Care

"An exciting, promising, practical, and brand new approach tosolving the cost/quality dilemma in managed care-high riskpopulation health management. This well thought-out program focuseson managing patients, not physicians." --Stuart Baker, MD,executive vice president of clinical affairs, Voluntary HospitalAssociation

"Status One represents a critical development for delivering on thepromise of improving the quality of care while simultaneouslycontrolling costs." --Sam Nussbaum, MD, executive vice president,Medical Affairs and System Integration, BJC Health System

"The management of this high risk group is critical to futuremanaged care success." --Joseph I. Berman, MD, chief medicalofficer, Anthem Blue Cross and Blue Shield

"Finally, a model of managed health care that resonates withphysicians and patients. A new direction for care management thatmakes sense on both humanitarian and financial grounds." --SanfordT. Kurtz, MD, vice president and chief medical officer, LaheyClinic 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. Status OneRepresenting only one percent of a provider's patients, those individuals at high risk for serious illness are undeniably the most challenging of all patient populations. This small set of patients typically account for up to forty percent of actual medical costs-often at the expense of both quality and profitability. To remain competitive, health care organizations must refocus clinical care on managing patients-not providers-and partner with patients, families, and communities to prevent the need for high-cost health care. Status One is the framework for this fundamental organizational change.Status One documents one of the most successful approaches to high-risk population health management, one that creates an aggressive system delivering consistently positive results. The leading architects of this pioneering approach-Samuel Forman and Matthew Kelliher-contribute to this comprehensive guide their firsthand experience and successes from programs across the United States.Co-published with the Healthcare Assembly Press, Status One provides health care leaders with a new strategy for improving quality while reducing costs and provides a new conceptual framework for population health management. Forman and Kelliher share proactive, practical methods with health care leaders so they can? Assess their organization's needs and potential readiness to adopt the Status One approach? Develop a care plan framework and a care integration strategy that meets the needs of both the organization and the patients most at risk? Identify patients most at risk and reduce their need for high-cost care? Gain insight into specific approaches to managing the most complex at-risk patients? Lay the foundation for improved care across the continuumStatus One, the first book of its kind in the emerging and specialized field of population health management, is critical to the future of managed care and will assist leaders as they strive to improve quali Status One

Representing only one percent of a provider's patients, those individuals at high risk for serious illness are undeniably the most challenging of all patient populations. This small set of patients typically account for up to forty percent of actual medical costs-often at the expense of both quality and profitability. To remain competitive, health care organizations must refocus clinical care on managing patients-not providers-and partner with patients, families, and communities to prevent the need for high-cost health care. Status One is the framework for this fundamental organizational change.

Status One documents one of the most successful approaches to high-risk population health management, one that creates an aggressive system delivering consistently positive results. The leading architects of this pioneering approach-Samuel Forman and Matthew Kelliher-contribute to this comprehensive guide their firsthand experience and successes from programs across the United States.
Co-published with the Healthcare Assembly Press, Status One provides health care leaders with a new strategy for improving quality while reducing costs and provides a new conceptual framework for population health management. Forman and Kelliher share proactive, practical methods with health care leaders so they can
· Assess their organization's needs and potential readiness to adopt the Status One approach
· Develop a care plan framework and a care integration strategy that meets the needs of both the organization and the patients most at risk
· Identify patients most at risk and reduce their need for high-cost care
· Gain insight into specific approaches to managing the most complex at-risk patients
· Lay the foundation for improved care across the continuum

Status One, the first book of its kind in the emerging and specialized field of population health management, is critical to the future of managed care and will assist leaders as they strive to improve quality of care, patient outcomes-and the bottom line.

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

"Status One represents a critical development for delivering on the promise of improving the quality of care while simultaneously controlling costs."
-Sam Nussbaum, M.D., executive vice president, Medical Affairs and System Integration, BJC Health System

"The management of this high-risk group is critical to future managed care success."
-Joseph I. Berman, M.D., chief medical officer, Anthem Blue Cross and Blue Shield