As this article in MedCity News notes:
“St. Joseph has many long-term employees who are now in their 50s and 60s, so its beneficiary base is relatively sick compared to the general population, CEO Dr. Rich Boehler said during an interview at HIMSS15 in Chicago.”
“We were wanting a better employee-benefit solution to reduce healthcare expenditures. We’re very committed to doing more than chronic disease management.”
Med City News says the goal is “to keep people who are at moderate to high risk for developing a chronic disease from ‘tipping over’ into a situation where they would need expensive, ongoing care like dialysis and to keep them out of the hospital, according to Boehler. ‘Once you have kidney failure, the jig is up,’ he said.”
“Initial analysis identified an interesting pattern. ‘One of the toughest things we’ve found this year is that our employees do fairly well. It’s their spouses who have the highest-acuity cases,’ Boehler said.”
“Data right now comes from insurance claims. We’re mining a claims database, but we marry it with the clinical information in our EMR,We’re able to risk-stratify.”
