A crucial tool for managing populations requires the use of a predictive modeler. The modeler should consider proportionally physical, behavioral, and social conditions. Additional components include:
Pharmacy activity and adherence
Lab/Radiology
Outpatient and admission activity
Specific measures (eg. HEDIS)
This population assessment creates many identified groups at risk based on:
Weighted proportions of the above elements (physical, behavioral, social)
A threshold for ER and admission activity in a defined time frame