Impact Insights

Population Health Management: Developing a Roadmap

Tonya Edwards

For the past several years the healthcare industry has been ablaze with discussions about “population health.” With the advent of Accountable Care Organizations (ACOs) and the gradual shift of both commercial and governmental payors to value-based payment, the race is on to develop population health management programs in US healthcare systems. But have we gotten the cart before the horse?

There is no generally accepted definition of population health management. Before embarking on development of a population health program, health systems should start with developing a health system specific definition of what population health management means to your organization; and a strategic plan. Here is an example of a working definition:

Population Health Management – A Working Definition

Information enabled, proactive application of strategies and interventions to defined groups of individuals across the continuum of care in an effort to improve the health of the individuals within the group at the lowest necessary cost. Central to the practice of population health management are:

  • Clinical Decision Support at the Point of Care Supporting Evidence-Based Care
  • Risk-Stratified Care Management Across the Continuum
  • Patient Engagement
  • Analytics, Reporting and Performance Tracking

Once you have agreed upon a working definition for population health management you can use this definition to guide program development.

Rather than haphazardly proceeding forward in a piecemeal fashion, the organization should then develop a strategic plan for the program, looking out three to five years. Strategic visioning exercises can help to define what populations you seek to serve, the degree of value-based payment penetration you expect in your market and in what time frame, the niche you would like to fill, and partners you may need to be successful.

Once these two critical steps are complete you are ready to assess your current state, identify gaps in people, process and technology, prioritize, and develop your roadmap to population health management.

 

This essay was originally featured in the December 2014 edition of the CHIME newsletter. Find more about Impact Advisors’ Population Health consulting services here.  

 

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