Understand Patient Population – Resource Library
- ACO Beneficiary Engagement Toolkit
- Association of a Care Coordination Model with Health Care Costs and Utilization
- Defining The Health Care System’s Role in Addressing Social Determinants and Population Health
- Delivering On Accountable Care: Lessons from A Behavioral Health Program to Improve Access and Outcomes
- Food, a Place to Sleep and Other Basic Patient Needs – The New York Times
- Housing, Transportation, And Food: How ACOs Seek to Improve Population Health by Addressing Nonmedical Needs of Patients
- The Opportunities and Challenges of the MSSP ACO Program: A Report from the Field
- To Curb Overuse of Low-Value Health Care Services, Engage Older Patients
The following resource(s) may be of value:
- Camden Group: Top-10 Characteristics of High-performing Healthcare Organizations
- Communicating Wisely: Design, Implementation and Outcomes of an Email-Based Care Transitions Bundle
- Findings from the Deloitte 2019 Health Care CEO Perspectives Study: Unique insights from industry leaders
- Leveraging Risk Stratification for Population Health Management
Health Value Atlas
Population Analysis
Understand Patient Population
Organizational capabilities related to understanding your patient population
Note: Some organizational capabilities cross over to other domains. There may also be some degree of capability overlap with Health Equity Advancement, Continuous Quality Improvement, and Health Information Technology domains.
Collect data
Collect medical and non-medical data
Aggregate data
Aggregate medical and non-medical data into a reliable data set
Analyze data
Extract actionable information from data
Automate data access
Automate timely access to data within and from outside the organization
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