Accountable Care

In Pursuit of the Triple Aim: Can Population Health Management Lead the Way?

By Fred Goldstein, MS and Gregg Masters, MPH

Every sector in health care is under pressure to articulate and implement a viable population health initiative that delivers on the triple aim of better health, better quality at a better cost.

Despite a significant investment of resources, we have only achieved ‘mixed results’ to date, and so the industry remains in a continuous learning mode. Although we’ve taken away some insights, we still have a long way to go.

Recently on Pophealth Week, we chatted with the ‘Dean’ of Population Health who spearheaded and continues to steward the nation’s first freestanding College of Population Health at Jefferson University in Philadelphia. David Nash, MD, MBA weighed in on the industry’s evolution — including best practices to emulate —and what near term challenges we are likely to face.

To listen to Dr. Nash’s take, click here, and for additional context checkout The Road From Volume-To-Value: The Pivotal Role of Population Health.

If you’ve worked in this space – at the strategy or operational level — you know that it can be truly daunting to implement a population health program. This can lead some organizations to shy away from attempting meaningful programs, perhaps even into a copycat ‘me too’ effort. Given the inevitable drive to value-based care, it is a strategic imperative to understand how to build and implement population health initiatives that work.

In its simplest framework, one can think of a population health program in terms of the following components as articulated by the Population Health Alliance Outcomes Guidelines Report Volume 6,  2015.

The steps of the Population Health Framework as shown in the image above include:

  • Identify the population
  • Assess the person for risk(s)
  • Stratify the person into risk levels to target for various interventions
  • Engage the person in a program
  • Intervene with specific services and resources and
  • Measure the process and outcome results

These results are then fed back into the system and the process continued all seeking to improve the overall health of the population.

In Search of Answers

One forum many look to for best practices and key insights is the Population Health Colloquium, now in its 18th year with the Jefferson College of Population Health as academic partner. Scanning this year’s Agenda, one can find presentations in each of the elements above.

Data and Analytics are the essential ingredients of any population health program with intent to identify individuals, assess them for various risks or conditions, stratify them to ensure appropriate levels of intervention and measure a program’s success.

Within the area of assessment, we are moving to an ‘N of 1’ approach given the advances in precision medicine and genomics. This exciting area will be covered at the conference in the mini summit entitled Personalized Medicine, Machine Learning and Genomics: a Clinical Approach to Employer Population Health and Wellbeing.

Payment models and the move to value-based care are among the key levers. Although there have been more than a few stops and starts along the way with the change in administration at the federal level, employers are rapidly embracing these approaches.  There are a number of presentations on this topic, including Journey to Value-Based Care — Experience and Expectations, Accountable Care Atlas: Mapping a Path to Value-Based Care and a Mini Summit ACOs at an Inflection Point: Where the Movement is Headed and Why Some Succeed While Others Don’t.

In the Intervention area, there are presentations covering ‘On the Ground: Population Health initiatives’… and we can’t forget about the patients — they, too, have a strong role to play in these efforts. The Mini Summit, Improving Patient Care and Provider Experience through Population Health Management, is timely and informative.

Community-based programs have become all the rage as we better understand the impact on your health based on where and how you live.  A breakout track entitled Population Health in the Community includes discussions on life expectancy gaps in Chicago; Rural and Urban Issues; and primary care and behavioral health that will address some of the approaches.

The program will feature a session on designing and implementing population health, and of course there will be some incredible keynotes and small panel discussions. The program includes a discussion with two former HHS Secretaries, Tommy Thompson and Michael Leavitt, and baseball great Darryl Strawberry will discuss addiction, a critical issue we are now facing with the opioid crisis.

If you are committed to learning more about Population Health, this meeting is a must. It’s an event where you can learn from experts covering the full breadth of population health services and have an opportunity to network. Whether you choose to travel to Philadelphia or attend via live webinar, please plan to join us and stop by to say hello. We’d love to hear all about what you’re doing in this exciting space.

==##==

This post is sponsored by the Jefferson College of Population Health

Advertisements
Accountable Care

The Road From Volume-To-Value: The Pivotal Role of Population Health

By Fred Goldstein, MS and Gregg Masters, MPH

Two macro trends are converging to further season and ultimately catalyze the transformation of the American healthcare enterprise: the predominant fee-for-service model that fuels the provider ecosystem (hospitals, health systems, medical groups, IPAs, ACOs, or managed physician networks, etc.) and their ‘partner’ financing plans, payors or administrators.

Ecosystem incumbents include national or regional commercial health insurers (payors), third party administrators (TPAs) that enable self-funding options for smaller employers unable to access the administrative services only (ASO) market, and the historically volatile ‘individual’ market.  And, no discussion of markets would be complete without considering the wide range of public sector initiatives including Medicare (Medicare Advantage and Accountable Care Organizations or ACOs) and Medicaid’s outsourcing to contract with managed healthcare organizations.

These two trends, seemingly at odds with one another, are on a collision course… and the health of our nation hangs in the balance. The burning platform regarding fee-for-service is commonly seen as driving a seemingly insatiable appetite for ‘more’, giving rise to widespread conversation and supportive health policy advocating ‘value based’ healthcare with an emphasis on qualityoutcomes and affordability.

The roadmap to achieving wholesale transformation of our system to focus on health is perhaps best reflected in the emerging science and practice of population health management.

Population health management depends on  business and service delivery provider/financing sector partnerships to achieve a sustainable healthcare ecosystem that enables the ‘triple aim’. Yet, the results of early population health management initiatives nationally are generally mixed, particularly when they neglect to consider the contextual social determinants specific to the target population and community.

In order to achieve that holy grail of improved health outcomes, we must have a clear understanding of the needs and available resources as well as a coordinated plan that includes all the relevant stakeholders.

To avoid the metaphoric outcome once opined by an Eastern Airlines (RIP) pilot emerging from the cockpit to announce to his passengers:

‘well folks, the good news is we’re making great time, the bad news is we have no idea where we’re going…’

The rest is legion for those who recall the death of legacy carrier Eastern.

Finding A True North – Grounding the Science and Best Practices of Population Health Management

The promise of managing populations efficiently and effectively, leading to a healthier overall America is something that just makes sense, whether the push is from the government, payers or providers. Where can one explore the myriad pieces of the population health puzzle to find out what’s working?  Fortunately, the upcoming Eighteenth Population Health Colloquium, March 19-21 in Philadelphia, Pennsylvania can provide some answers.

This conference, chaired by David Nash, MD, MBA, Founding Dean of the College of Population Health at Jefferson, the first such institution in the country, provides the opportunity to hear from and network with some of the biggest names and companies in the field.

Whatever your area of interest — policy, data and analytics, program design and development, provider-based programs and ACOs, payer-based programs, value-based care and contracting, social determinants of health, technologies or even personalized medicine — .  Dr. Nash and his team are bringing together world class leaders and in a right-sized setting that supports interactions with speakers and networking with other attendees.

If you haven’t been to this conference before, now is the time, as health and healthcare system and communities at large are turning to population health.  Be part of this transformation by attending the Colloquium!

For an invitation to the 18th Population Health Colloquium David Nash, MD, MBA, Dean of the Jefferson College of Population Health provides an overview of what to expect (click image).

For the 3rd year in a row Health Innovation Media will be on the ground interviewing keynote speakers, conference organizers, select sponsors and exhibitors committed to supporting the emerging population health focused economy.

Follow the Colloquium via @pophealthconf. The digital dashboard accessible via #phc18 including newsworthy tweets associated with the Colloquium.

For more information or to register, click here.

==##==

This post is sponsored by the Jefferson College of Population Health

 

 

 

 

 

Accountable Care, ACO, population health

Three Days in Scottsdale: Unbundling the Triple Aim?

By Gregg A. Masters, MPH

With the simultaneous running of the 6th Annual mHealth Summit (follow #mhealth14), Population Health Alliance [PHA] Forum (follow #PHAforum) and Institute for Healthcare Improvement [IHI] (follow #IHI26Forum) I am reminded of the oft quoted Don Berwick, the then Administrator for CMS channeling from his tenure in healthcare both as a clinician and ‘truth to power’ health wonk, of the ‘all hands on deck’ and ‘full court press’ nature of the challenge before the health[care] ecosystem stakeholder ‘leaderbody’ – if you will.PHA Forum 2014 via @ACOwatch

I have chosen to express his challenge more broadly as the mandate to pursue and enable a sustainable healthcare economy, since ‘business as usual’ is no longer even a remote option placed before any credible healthcare leadership whether inside, aligned with or otherwise tethered to the healthcare ecosystem sporting either traditional provider, recipient (patient/consumer) or payor stripes.

The HealthInnovation Media team is on site (me and my co-host colleague Douglas Goldstein aka @efuturist) In Scottsdale at the PHA Forum to interview keynote speakers, session leaders and interested parties to the arguably ‘nascent’ [or minimally rebranded] population health industry.

Just what is ‘population health’ you might ask? Is it ‘Disease Management 2.0’ rebranded and extended into the lifestyle or health side of the equation? Or is it some other programmatic expression yet to be fully defined and operationalized based on local provider/payor geo-political footprints?

The PHA Forum program committee has assembled a thoughtful line-up of talented folk at the PHA Forum 2014 who will address that subject. In particular, I am looking forward to hearing the perspectives (and data) from the founding Dean of the only School of Population Health Management (follow via @JeffersonJSPH), The Jefferson School of Population Health, David Nash, MD, MBA.

For the complete program agenda, click here. You can follow the twitter stream for this event via #PHAforum.