Population health management isn’t just a quick fix. It’s an entirely different way to view your patients; it’s culture change. Instead of the traditional focus on individual patients, population health programs look at the needs of an entire community or patient population. It’s what Georgetown University Professor Larry Gostin calls “saving statistical lives” – creating or enhancing prevention and wellness initiatives that keep people from getting sick.
There’s no doubt we have a cost imperative in the U.S., and health statistics from other developed countries suggest that many Americans aren’t getting enough from our healthcare system. Despite all the cutting-edge technologies in clinical care and the new, innovative products being developed every day, 1 in every 2 Americans have a chronic disease. And chronic diseases account for 70% of deaths each year.
The part we’ve been missing, prevention and wellness for the broader population, is outside of the traditional realm of our systems. U.S. health systems provide excellent, high-quality sick care, but what about care to keep people well?
All that is changing.
In Premier’s fall 2013 Economic Outlook, “Population health: Unlocking the value of healthier communities,” health systems discuss the ways they’re building healthier communities.
We surveyed CEOs from our member health systems and 12% identified population health as their top strategic initiative for the next 12 months, compared to only 3% last year.
2 key takeaways from our survey respondents:
Change is clear
- 50% of respondents say they’re currently building partnerships to enhance their organization’s ability to manage population health
- 75% are engaging with their internal physicians and practitioners to create new, or enhance old, internal initiatives like disease management programs
- 50% are working with community groups and public health departments in their areas
- 50% are partnering with large local employers and payers
Population health management requires scale in a variety of ways. Most importantly in terms of the number of patients covered and having data on those patients. Partnerships, like those with payers and large employers, build scale by providing claims or other population data that can help providers accurately stratify risk in their population.
In fact, 64% of respondents are integrating clinical and claims data as part of their strategy to manage population health. 45% are using predictive analytics to forecast patient/population needs. And 44% are using an integrated data solution across clinical, supply chain and other databases to reduce data silos.
Data is an integral part of improving population health while reducing healthcare costs. Stratifying risk across a patient community helps providers determine what types of programs could be beneficial, and for which patients. And it aids in reducing overall costs, since it should keep patients from needing more costly emergency care.
Care coordination is essential
Improving care coordination is a main focus of the Affordable Care Act. It’s considered essential in pay-for-performance models that emphasize appropriate care pathways, and in reducing readmissions. The rise of accountable care organizations (ACOs) demonstrates how health systems are improving care coordination, and ultimately reducing costs while improving outcomes. Among survey respondents, 27% have already joined or created an ACO and only 23% do not have plans to join or create an ACO in the foreseeable future.
Accountable care and population health are intrinsically tied, though health systems do not need to be part of an ACO to undertake population health initiatives. ACOs seek to improve care beyond hospital walls and across care settings, while also managing the spectrum of wellness to sickness.
Of the 9 top areas of resource dedication for population health, according to survey respondents, 5 of them occur outside of the traditionally acute medical care system:
- Lifestyle and wellness coaching (67%)
- Home health (56%)
- Transitional and/or end-of-life care (55%)
- Patient-centered medical homes (51%)
- Telemedicine/virtual care (38%)
Connecting the dots to population health
Though we still have to work to do to move away from a historically fragmented structure, the Affordable Care Act and our own health statistics and cost imperative have propelled healthcare providers into action.
It’s clear from our survey results that member health systems aren’t resting on their laurels. They’re actively engaged in crafting the programs and infrastructure that promote healthier communities, and they’re doing it by:
- Engaging in new partnerships
- Building scale in data and informatics to better understand the needs of their communities
- Expanding their reach in terms of services and care settings
- Putting it all together to create multidimensional well-care programs
What we can all agree on is the need to leverage every opportunity to successfully manage the health and wellness of a population.