MMHA 6540 Week 4 Need Ranking Matrix Example

Falls, Isolation, Medications or Food? A Weighted Need Ranking Matrix for Prairie Gate's Older Members

Student Name

Walden University

MMHA 6540: Population Health Management Applications

Instructor Name

Month Day, Year

Falls, Isolation, Medications or Food? A Weighted Need Ranking Matrix for Prairie Gate's Older Members

Purpose

Prairie Gate Health Plan will fund one population health initiative for its older members this year. Four needs are candidates: falls, social isolation, medication burden and food insecurity. This matrix ranks them against four criteria agreed before scoring, with weights that sum to 100, then tests whether the ranking holds under different weights. All weights and scores are illustrative, but each score cites the evidence behind it.

Criteria and Weights

Table 1 defines the criteria.

Table 1

Criteria, Definitions and Weights (Illustrative)

Scores

In Table 2, each need receives a score between 1 and 5 per criterion, alongside a note on the evidence.

Table 2

Need Ranking Matrix (Illustrative Scores)

Reading the Scores

Falls rank first. The falls burden profile found about 1,100 members at clearly elevated risk, avoidable spending that lands on the plan's own claims through emergency care and hospital stays (Florence et al., 2018), partners already active in the metro county, and outcomes that appear in claims within months. Interventions such as exercise programs reduce falls among community-dwelling older people (Sherrington et al., 2019), and home safety modification reduces falls among those at higher risk (Gillespie et al., 2012).

Social isolation ranks second on importance but third on the weighted total. It affects many members, and its health effects are well documented (National Academies of Sciences, Engineering, and Medicine, 2020), but its costs to the plan are indirect, its rural partners are thin and the plan has no routine way to measure it. Medication burden ranks second overall, held back by uneven practice participation in pharmacist reviews and by the difficulty of linking specific admissions to specific drugs. Food insecurity ranks last, mainly because no rural partner can deliver food to homes, and because nothing in the plan's current records would show whether members ate better after a program began.

Sensitivity Check

Table 3 reruns the totals under two alternative weightings.

Table 3

Weighted Totals Under Alternative Weightings (Illustrative)

What the Sensitivity Check Shows

Falls rank first under all three weightings. The order of the other needs changes: under the members-favoring weights, social isolation moves ahead of medication burden, reflecting how many members it affects. The result suggests that the choice of falls does not depend on a particular weighting, while the choice of a second initiative, if the plan later funds one, would depend on how leaders weigh reach against cost.

Recommendation and Caveats

I recommend that Prairie Gate's initiative this year address falls among older members, beginning with the 1,100 members identified in the burden profile. Social isolation should be revisited next year, ideally after the plan adds a loneliness question to its annual health assessment so that it can be measured. The matrix has limits. Scores are judgments, even when evidence supports them. The matrix favors needs whose results appear quickly in claims, which disadvantages needs like isolation whose benefits may be large but slow. And a single initiative cannot address the overlap between needs: many members who fall also live alone and take many medications. The falls program should be designed to notice those overlaps, for example by including a medication review and asking about isolation during home visits.

How the Scores Were Set

Scores were set by a small group, the population health analyst, a care management nurse and the plan's medical director, working independently from the same evidence summary and then meeting to resolve differences. Where they disagreed by more than one point, the evidence note was rewritten to state the disagreement. That happened twice: on partner readiness for social isolation, where the nurse knew of a rural church network the others did not, and on measurability for medication burden, where the medical director pointed out that adverse drug events are often coded vaguely. Recording these disagreements matters because a matrix can look more certain than the judgments behind it. A reader who disagrees with a score can change it and recalculate, and the sensitivity table shows that changing a single score by one point would not move falls from first place. Before the next cycle, the plan should collect better data on the weakest-scored criteria, particularly measurability for isolation and food insecurity, so that those needs can compete on evidence rather than being held back by missing information.

References

Florence, C. S., Bergen, G., Atherly, A., Burns, E., Stevens, J., & Drake, C. (2018). Medical costs of fatal and nonfatal falls in older adults. Journal of the American Geriatrics Society, 66(4), 693-698. https://doi.org/10.1111/jgs.15304

Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Sherrington, C., Gates, S., Clemson, L. M., & Lamb, S. E. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 2012(9), Article CD007146. https://doi.org/10.1002/14651858.CD007146.pub3

National Academies of Sciences, Engineering, and Medicine. (2020). Social isolation and loneliness in older adults: Opportunities for the health care system. The National Academies Press. https://doi.org/10.17226/25663

Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., Clemson, L., Hopewell, S., & Lamb, S. E. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 2019(1), Article CD012424. https://doi.org/10.1002/14651858.CD012424.pub2