The Health Plan has a population health management strategy that identifies and stratifies our enrollment population-based on medical conditions, risk factors, and social determinants of health.
Data is reviewed to assist in developing programs to meet the needs of various risk groups and engage both members and providers in improving the overall health of the populations.
Included in the assessment is the review of gaps in care related to evidence-based practice as well as member satisfaction with clinical services programs. Additionally, further analysis of specific high-risk groups, such as children with special healthcare needs, members with disabilities, and those with severe and persistent mental illness, is completed to ensure the needs of those members are identified.
The analysis of this comprehensive assessment is shared internally at The Health Plan as well as with network physicians to support alternative payment relationships, including value-based arrangements.