We’ve heard the skeptics. All this talk about transforming health care? Been there, done that. Accountable care, bundled payment, team-based care that fully involves the patient and family in decision-making? Just the latest big ideas, they scoff, fated to flare and fade like all those earlier big health care ideas.
Take population health management. Cynics say it’s just another version of managed care with similar, admittedly admirable, goals of lowering costs and improving both quality and patient satisfaction. But in the end, all managed care really managed to do was annoy consumers and send providers and insurers running for the exits. And, so the thinking goes, population health is doomed as well.
I beg to differ. A lot has changed in the years since managed care fizzled. For one thing, technology now allows us to collect and analyze patient data in real time, which makes understanding and managing health incidents and trends a much more flexible, more fleet-footed and altogether more sophisticated enterprise. Issues can be identified swiftly and tactics for dealing with them implemented and modified accordingly.
For another thing, the frustration over health care costs has gained traction, not only among employers, insurers and policymakers, but also among the American public. There’s a deeper awareness generally that we have to rein in cost growth for the good of the nation, which involves not only treating disease, with a special emphasis on high-cost, chronic illness, but on keeping people healthy in the first place.
Hospital leaders understand and want to help make it happen, and the incentives and penalties mandated in federal and private market reform efforts add to the urgency to do so. As complicated as it is for providers to move toward value-based payment while still living in a largely fee-for-service world, most hospital professionals accept that change is coming — big, transformational change — and they’re working hard to figure out how they will survive and thrive in this evolving landscape.
In the February issue of Hospitals & Health Networks, our cover story takes an in-depth look at just what population health means in all its manifestations. How do you define the "population" you are targeting: by geography, by type of disease, by age, by socioeconomic status or by any number of other criteria? Our article, "Population Health: The Risks & Rewards," written by Howard Larkin, examines hospitals and health systems of varying shapes and sizes, and how they are targeting particular patient populations and tailoring population health management programs to successfully meet measurable standards.
Near the back of the issue, in our monthly The Extra Mile article, writer Laura Putre profiles a former Wall Street executive for whom 9/11 prompted a re-evaluation of her life’s goals. She left big business and developed a wide-ranging health outreach program for her Korean-American community in New Jersey. The program, now sponsored by Holy Name Hospital in Teaneck, is another example of population health management, this time focused on a particular ethnic community.