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Hotspotting Alone Is Not Sufficient

Hotspotting Alone Is Not Sufficient

A recent randomized, controlled study of “hotspotting” efforts by the Camden Coalition of Healthcare Providers, has drawn a lot of media attention. The study’s conclusion – that focusing resources on the sickest patients does not seem to be keeping them out of the hospital – has caused some healthcare observers to question the value of population health programs that target specific patients for intervention. Is such intensive care management well intended, but largely ineffective?

CCNC’s Impactability Approach: How “Finding the Needle in a Haystack” Continues to Yield Savings from CCNC Care Management, a new data brief released by Community Care of North Carolina, Inc. (CCNC) argues that effective targeting of patients can in fact significantly impact health trajectories, reducing both costs and reliance on emergency rooms and inpatient care.

CCNC’s approach evolved from over a decade of experience conducting internal, controlled evaluations of its care management programs. Emerging data and real-world experience within CCNC continues to inform targeting algorithms. The resulting approach – Impactability™ – has allowed CCNC to avoid the pitfalls of similar-sounding programs that focus on just the highest-risk patients. Impactability does more than just identify those characteristics that are believed to be amenable or patients whose utilization appears to be preventable. Rather, it identifies those that CCNC has demonstrated do in fact benefit, along with the ability to estimate the relative magnitude of such impact. Additionally, Impactability™ provides guidance not just on whom to target, but also the type and intensity of intervention. This further maximizes the return-on-investment from limited care management resources.

But, analytics is never enough to make an impact on a patient population. A key component of CCNC’s success is North Carolina’s history of robust community partnerships and a strong base of engaged, committed primary care physicians. This infrastructure has provided a necessary foundation for programmatic success. Supported by the energy and determination of physiciansacross the state, CCNC has been able to incrementally lower costs and utilization among North Carolina’s Medicaid population. Recent initiatives by the State’s DHHS to address social determinants of health, including NCCare360, are poised to help North Carolina achieve even greater success.

For more information about CCNC and Impactability™, please contact VP for Communications Paul Mahoney.


Download Data Brief No. 12


Hotspotting Alone Is Not Sufficient