The Next Level of Health Benefits is Personal

When we analyze population claims data, it’s common to group it by diagnosis or place of service, which can lead us to see individuals as illnesses rather than whole people—ultimately limiting the effectiveness of our strategies. Advancing healthcare benefits requires rethinking how we engage with and serve individuals by recognizing their unique identities and needs. Incorporating demographic variables into data analysis can uncover hidden opportunities and lead to more equitable, person-centered care. This balance is achieved through optimizing the “Goodness of Fit” between patient and provider—ensuring people have access to professionals who are not only evidence-based, but also culturally sensitive and emotionally intelligent. For example, network management strategies that emphasize whole-person care call for broader provider networks, allowing individuals to find the best fit for their care needs. PROACTIVE CARE follows this approach, starting with wide networks and refining them based on local outcomes. A recent study illustrates why this matters: despite having similar predicted cardiovascular risk, Black adults experience disproportionately higher long-term mortality rates compared to other groups, suggesting that existing models fail to capture the full picture of risk and care needs.

Rosenblatt, S, Blaha, M, Blankstein, R. et al. Racial and Ethnic Differences in Long-Term Cardiovascular Mortality Among Women and Men From the CAC Consortium. J Am Coll Cardiol Img. null2025, 0 (0) .https://doi.org/10.1016/j.jcmg.2025.01.013