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Persona Based Population Strategy


Mar. 18, 2015
Recorded Online

1:00 - 2:00 p.m. EST

A typical care management program involves profiling members based on their disease states, without taking into account other dynamics regarding the patient as a whole. A dilemma in identifying members based on their disease and/or high cost attributes alone, is that high costs in year one have often are an inadequate predictor of high costs in year two.

Starting in the Fall of 2013, CareSource initiated a population based clustering model using claims and enrollment data to segment their members into specific personas, and then launched services to members based upon the persona in which they were identified. CareSource is a nonprofit health plan is celebrating 25 years as one of the nation’s largest Managed Medicaid Plans. Headquartered in Dayton, Ohio CareSource serves more than 1.3 million consumers in Ohio and Kentucky.

CareSource's innovative persona approach has transformed their care management for acuity based care coordination using cluster analysis to yield outputs of clinical personas. These personas result in population subsets requiring unique member interaction for tailored interventions.

Personas have been traditionally used in market research to depict clusters. Utilizing this approach, CareSource, for example, started with three such marketing personas: Well/Acute; “Acute” Episodic; and Chronic Complex, and deployed a cluster drill down into nine clinical personas, that became actionable subsets.

Please Join CareSource's Bob Gladden and Cathy Meade as they discuss CareSource's Persona Based Population Strategy on Wednesday, March 18th, 2015 from 1PM until 2PM Eastern, during this HealthcareWebSummit event on incorporating predictive modeling into member care.

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