Healthcare’s New Imperative: Population Health Management

Now that the Patient Protection and Affordable Care Act (PPACA) has received the Supreme Court’s stamp of approval, healthcare providers must determine the best way to improve quality and safety while simultaneously reducing cost. According to the Agency for Healthcare Research and Quality (AHRQ) Practice-Based Population Health: Information Technology to Support Transformation to Proactive Primary Care Report, the proactive measurement and management of a panel of patients may be one means of transforming the current healthcare delivery approach.

As defined by the Health Research & Educational Trust, population health management provides a strategic platform to improve the health outcomes of a defined group of people, concentrating on three correlated stages:

The distribution of specific health statuses and outcomes within a population;
Factors that cause the present outcomes distribution; and
Interventions that may modify the factors to improve health outcomes

To succeed at population health management, effective strategies for increasing the prevalence of evidence-based preventive health services and preventive health behaviors, improving care quality and patient safety and advancing care coordination across the health care continuum must be implemented.

The Care Continuum’s report, Measuring Population Health: 2010 Outcomes Guidelines Report Volume 5, sets forth a framework for achieving healthcare quality improvement. Utilizing health risk assessments, medical claims, lab and other data, individual’s health/emotional risk can be quantified and addresses accordingly. Through face to face, mail, email, telephonic, social media, online education & coaching and other interventions, healthcare providers can work with patients to modify behavior and improve health status. In order to cement long-lasting and continued success, care coordination and appropriate incentives must flank the framework. Through improved health status, by-products of higher satisfaction and productivity with corresponding decreases in health service utilization and cost will occur.

In order to prepare for increasing numbers of aging, chronically ill and insured patients in the face of value-based purchasing, many organizations have already started down the path of population health management. While population health management remains in its infancy, the Care Continuum has identified key issues for future success of this increasingly important strategy:

Accountable Care and Medicare Shared Savings Program – will these continue to be vehicles for healthcare reform?
Consumer Use of Mobile & eHealth Technologies – healthcare is moving to a patient-centered, consumer-empowered, pull-rather-than-push model
Reducing Medicare Hospital Readmissions – can this strategy effectively facilitate the Hospital Readmissions Reduction Program (HRRP)?
Quality Improvement- the need to demonstrate improvement in wellness and chronic care measures will drive expanded opportunities
Improving Care Coordination for Dual Eligibles – can population health management drive efficiencies for the Federal Coordinated Health Care Office?
Federal and state health insurance exchange support of prevention and wellness

Having recently hosted the Population Health Innovations Showcase in Washington, D.C., the Care Continuum Alliance continues to keep the country focused on healthcare’s new imperative: population health management.

*graphic courtesy of SHPS

Healthcare’s New Imperative: Population Health Management