Population Health Management is Key to Value-Based Care
By Justin Lanning
A group of 35 C-level healthcare executives polled at the recent Midas+ Annual Symposium unanimously agreed that population health management is necessary as the U.S. shifts to more value-based healthcare reimbursement and delivery models.
The group of executives, which collectively represents over 80,000 beds from more than 480 hospitals, was asked to provide their perspective on population health management, starting with how it should be defined. We asked them to rank five components of a definition in order of significance.
According to this group, the most important requirements of a population health management program are that it “facilitates care across the health continuum” and that it “supports providing the highest quality of care at the lowest cost.”
What is population health? Definition components were ranked in the following order:
- Facilitates care across the health continuum
- Supports providing the highest quality of care at the lowest cost
- Uses actionable insight for patient care based on a variety of data
- Targets a specific population of individuals
- Enables patient engagement
And healthcare executives today aren’t just talking about population health; they’re putting real emphasis behind it. Our survey found that providers are optimistic about the progress their organizations can make, with 65 percent stating they believe their organizations will deliver fully-scaled population health management programs within five years, while 16 percent report their organizations area already doing so. It makes sense – with providers compensated for successful health outcomes, it’s critical for them to focus on effective management of patient populations.
But as with any major shift in an industry, there are a number of barriers to successful implementation and adoption. Survey respondents indicated the number one challenge is data management and integration capabilities, followed by a lack of financial incentives, poor coordination across care providers and the ability to create meaningful data that provides actionable insights
Ninety-five percent of an extended network of over 150 healthcare staff polled at the symposium believes their role at their healthcare organization will be impacted by an increasing focus on value-based care within the next two years. But how will providers actually make that transition? It’s helpful to look at one example that illustrates how this can come to life:
An analysis of statewide historical hospitalization data in Hawaii revealed high rates of preventable admissions due to bacterial pneumonia. Statewide data showed a pneumonia vaccination rate of 61 percent for men age 65 or higher, and a vaccination rate among Filipinos age 65 or higher of just 51 percent – much lower than the Healthy People 2020 target of 90 percent set by HHS.
Studying geographic data, Hawaii hospitals identified neighborhoods with high bacterial pneumonia hospitalization rates and high Filipino populations across the state. One hospital initiated a plan to increase vaccination among those populations through targeted community benefit activities and increased efforts to vaccinate the managed care population. The estimated potential cost avoidance for Hawaii if the target of 90 percent is reached is over $1.8 million.
Clinical decision support tools that offer consumer insights and engagement opportunities can provide critical support for providers who are looking to better manage care coordination, patient engagement, and chronic diseases, which can be too complex for staff with limited time and resources to handle on their own.
In addition, these tools address data management challenges by predicting health outcomes and providing actionable ways for clinicians to intervene and improve individual care – stated by polled executives as the as the most important driver of population health.
However, providers need to choose a trusted technology partner with proven methodologies. Our discussions with the executives at the symposium reveal that they are taking a staged approach to population health by implementing programs for targeted populations and scaling as they show success.
Justin Lanning is senior vice president and managing director, Midas+, A Xerox Company.