Using Risk Models in Healthcare

A non-mathematical guide for health professionals

Image: Business people, computer and analytics by LumiNola, licensed through iStock for use

Risk modeling and risk scoring in healthcare can be complex, but their use and development doesn’t have to be. Anyone can understand their fundamentals and feel more confident with them, even if you don’t have a mathematical background.

This guide is for those who aren’t deeply versed in actuarial science or statistics. It aims to make the concept of risk models more approachable and help you understand how to effectively use or even contribute to their development within your healthcare organization.

In a previous issue of Health Data Guru, I wrote about the many (many, many) predictive risk models in healthcare. We covered their types, uses, and limitations. If you’re unfamiliar with risk models and risk scoring, that’s a good starting point.

Building on that, this article aims to further your understanding, covering:

• Terminology Basics: Clarifying terms like risk, risk model, risk score, and risk stratification
• Real-world Barriers to Adoption: Why these models aren’t always instantly and unanimously embraced by case managers, care teams, operations or finance teams, analysts
• Examples and Ideas: Concrete…