Intelligence Report: Toward Population Health

Michael Zeis, for HealthLeaders Media , October 14, 2013

Data and analytics

Two-thirds of survey respondents (66%) expect to invest in integrating clinical data across the care continuum, and 53% expect to add to their data analytics capability. While the investments are likely to be substantial, Steinberg observes that access to data is a necessary component of population health management. "It's not just the expense," he says. "There has to be cooperation from the payers. Providers need data from payers. Some payers are providing it, some payers aren't. Some payers are providing it in a form that's usable; others are providing it in a form that winds up just chewing up time while you try to make sense of it."

More than half of the respondents (56%) say their organizations need training in data analytics, and 44% need training in population statistics. Nash describes how physicians might be guided by a system with well-developed registry and reporting functionality. "As a physician, I ought to be able to assess instantly and graphically how I'm doing in the care of a population of patients and how my care compares to a peer group at the local, regional, and perhaps even national level." Getting useful functionality requires more than buying and installing software. "I'm going to need a whole new type of information technologist," Nash says.

The expectation that IT tools will be available to monitor and guide population health activities on several levels is what will help Lancaster General's pending ACO function as a population health training ground. Says McGowan, "The accountable care organization serves as the vehicle, but we are doing it because of the new intelligence we will gather around the opportunity to improve not only value, but quality." Still, McGowan is concerned about software costs. "Because they're just becoming available, the tools are very costly."

Population health management presents many challenges, particularly with data and data analytics, new and unfamiliar partners or working relationships, and pressure to reduce costs and increase efficiency. But the overarching requirement when examining population health is that healthcare institutions have to prepare themselves to bear risk. And at its core, the requirement to bear risk is financial in nature, so all of the tendrils of population health management must be examined first from a financial perspective. For some, the financial examination may be the grim task of examining sustainability.

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This article appears in the October issue of HealthLeaders magazine.

Michael Zeis is a research analyst for HealthLeaders Media.

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1 comments on "Intelligence Report: Toward Population Health"

bob sigmond (10/14/2013 at 11:19 AM)
The best and easiest way for hospitals and health systems to embrace the new model of population health is to collaborate with a Blue Cross plan or other insurer which already understands population heath. Together the two organizations can design a strategic plan for transitioning to population health and agree on an annual provider budget that carries out that strategic plan. This will work best if the hospital turns over its entire billing and collection function [and collection staff which remains at the provider site] to the collaborating third party payer organization which takes over all collections and pays the hospital/health system a single monthly check that covers all the provider organization's expenditures. This avoids the provider organization having to duplicate all the initial preparatory work that the third party payer organization has gone through in becoming expert in population health. With no more involvement with fee-for-service and collections, with no more uncompensated care, and with no more worry about the bottom line, the collaborating provider organization can concentrate on incrementally transitioning into population health, with its collaborating third party payer organization, with goals of increasing quality and access while reducing expenditures. Clearly, many details have to be worked out, including [a] the method for making adjustments whenever the expenditure budget estimates turn out to be too low, [b] how to divide up any net gains or losses at the end of the year, etc. But with trust between the two collaborating organizations, the transition to population health will be remarkably easy and effective. For more information about this approach, call me at 215-561-5730 or e-mail. Right on! Bob




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