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Move over risk scores, what healthcare needs now is Risk Science

August 06, 2018 / John Supra and Shrujan Amin

“What’s their risk score?” That’s a natural question to ask when a discussion arises concerning patient risk. Unfortunately, it’s also how most conversations both start and finish. The idea is that a single score sorted from highest to lowest will tell you which patients need your attention, regardless of the person’s specific clinical or social needs or the care programs that you may be able to offer them. Indeed, historical models based primarily on claims data aim to capture a general health status of a patient and were designed around the actuarial prediction of future costs. But as we drive toward value-based programs where providers share insignificant risk this approach is no longer adequate.