We hear the phrase "population health management" bandied about quite a bit these days, sometimes from folks who I'm not even sure could define it, if put on the spot. But what exactly are the building blocks and competencies needed to survive and thrive in this new way of doing business?
I attempted to get to the bottom of that question in this month's H&HN special foldout section, "The Fundamentals of Population Health Management." The piece breaks down your hospital's road to realignment into easily digestible tidbits — from parsing patients into different groups, to analyzing data and targeting interventions.
Brian Silverstein, M.D., population health expert and president of consulting firm HC Wisdom, told me in an interview for the story that defining what this new reality looks like for your organization is a solid start.
"The first step for a health system is gaining a baseline understanding of what population health really is," Silverstein said. "Because oftentimes, they're stepping into this not really knowing, and what you realize is that, if you're a health system, everything you do is organized around collecting money and fees for different services. And when you're a population health manager, everything you do is organized around how to take better care of patients for lower costs, and those two things are in opposition with each other."
In the piece, we delve into some of the key components of a population health management system and, as you can imagine, they go well beyond just doctors and nurses putting heads in beds. Carroll Hospital Center in Westminster, Md., has aligned itself with key players across the continuum and driven care to the lowest cost and most convenient setting, be it a retail clinic or urgent care clinic.
A recent surveyof C-suite leaders by Premier Inc. found that 71.6 percent of respondents named lifestyle/wellness coaching as top on leaders' lists of the resources needed to pursue population health. Other top tools on the list include patient-centered medical homes (62.4 percent), transitional and/or end-of-life care (61.5 percent), and home health (56.9 percent). Telemedicine is also critical, particularly for isolated rural or stand-alone hospitals, with about half of such institutions championing the approach. This is compared to just one-third of non-rurals.
In the new world of population health, a lot of the old excuses start to wither away, according to Silverstein.
"If you look at the reasons why patients die prematurely or experience poor outcomes, often it's because of behavioral issues, not necessarily because of health care," he told me. "People have a tendency to say, 'Boy, there's nothing we can do about that.' Well, a lot of population health management is really focused on changing behaviors and putting the necessary people and resources — social workers, community health workers, pharmacists, nutritionists, etc. — in place."
Of course, doing so can be difficult when you're not getting reimbursed for such services. Experts told me that you have to pay attention to the dynamics of your market, and how quickly payers and employers are aiming to change care. Switching to a new payment model when the old one is still paying the bills can be the biggest challenge in this transition. "We don't do the right thing for patients because there's not a financial model for it, and I see population health as bringing that financial model to bear," Silverstein said. "But, appreciate that it can be at the expense of an existing volume-based model."
What's your hospital or health system found to be some of the essential ingredients to population health management? Share your thoughts and experiences in the comment section below and, for more on the topic, check out our October cover story, "How Will You Adapt to Population Health?"
