Download - Dr. Hank Gardner's Stanford MedX Human Capital Risk Index (HUI) Presentation -- HCMS Group
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TELEHEALTH APPLICATION OF PREDICTIVE ANALYTICS TO DRIVE PATIENT-CENTRIC CARE:
A Solution for the 5% Problem
Dr. Harold (Hank) GardnerHCMS Group CEO
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• Risky overutilization of medications, testing, and specialists
• Poor access & utilization of primary medical care & prevention
• Significant utilization of lost time and workers’ compensation benefits
• Typically at out-of-pocket maximum, so utilization is free
• Higher utilization with family members
• Over 20% migration into and out of the 5% each quarter5% of people driving 56% of costs
$People
#5PercentProblem
The 5% Problem Population That Drives Over 50% of Health Benefit Costs
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Human Capital Risk Index® (HUI) – Patent Pending
Unique HUI Features:
• Econometric (Versus Actuarial)
• Predictive Index (Versus Lagging)
• Person-Centric (Versus Disease-Centric)
• Comprehensive – Medical, Pharmacy, and Lost Time
• Uses More Than 300 Weighted Risk Variables#HUIRisk
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VARIABLE WEIGHT
Lung Cancer 4.50
Asthma 0.15
Respiratory Agent 0.05
Anti-Infectives 0.05
Short-Term Disability 1.35
Workers’ Compensation 2.25
Total HUI Score 8.35
5% Person: Individual Health HUI Risk Profile
#HUIRisk
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Population Health Risk Analysis: Cost and HUI
0.5
1.4
2.8
5.2
0.0
1.0
2.0
3.0
4.0
5.0
6.0
0
200
400
600
800
1,000
1,200
50% 30% 15% 5%
Ave
rage H
UI S
core
Popula
tion
Percent of Population
Average HUI = 1.3
$465
$2,987
$11,927
$61,751
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
0
200
400
600
800
1,000
1,200
50% 30% 15% 5%
Ave
rage M
edica
l Cost
Popula
tion
Percent of Population
Average Cost = $5,987
5% of people drive over 50%
of costs
HUI risk is predictive of cost
#PopulationHealth #HUIRisk
= Population = Population
= Cost = HUI
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5% Population: Annual Health Benefits Utilization Analysis
Bottom 95% Top 5%
Medications 3 10
Providers 4 11
Diagnoses 4 13
Tests 7 33Average Individual Integrated Cost $2,383 $40,729
Human Capital Risk Index® (HUI) 0.86 4.06
Health Risk Assessment (HRA) Self-Report Risk Score
90.3 89.5
#5PercentProblem #HUIRisk
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5% Population: Disease Cluster Comorbidity Analysis
#Comorbidities #HUIRisk
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HUI Telehealth Clinical Decision Support Model
Secure Internal NetworkBenefits Sponsor
Clinical Service
Documentation
Patient-Centered Care
Electronic Health Record
Clinical Decision Support Provider
Data
• HR
• Compensation
• Medical
• Pharmacy
• Lost Time/STD
• Workers’ Comp
On-Demand Clinical Decision
Support iHUI
#HUIRisk
HIPAA- Compliant
Data Warehouse
& Predictive
Analytic HUI
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Telehealth 5% Solution Results
Right services to the right person at the right time
WasteSpecialty Care & Prescription
Drug Cost
Person-Centric
Primary Care & Prevention
Health As Human Capital
Cost Savings & Resource for Worker
Wages
#HUIRisk
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