By Pearson Talbert, CEO of Aegis Health
Today, more than ever before, hospitals must have a strategy in place to proactively address Population Health Management. Hospitals are increasingly expected to serve as more than a place where patients come when they are sick or injured. The growing mandate of “accountable care” provides financial incentives for physicians and hospitals to improve population health by implementing preventative care programs designed to mitigate health risks and thereby reduce the costs of healthcare within their respective markets.
Here are five ideas that you might incorporate into a hospital based strategy for Population Health Management;
1. Be proactive and connect with the broader community and employers. We’ve all heard that hospitals today need to become true centers of health, and move beyond the sick care models where a win was an admission and was counted by the average daily census. A great place to start is by analyzing what can be done outside the walls of an inpatient setting to raise awareness of health issues and communicate achievable health goals. Some healthcare organizations are hiring executives and support staff to develop their brand through community and employer outreach programs. Be proactive; don’t wait for the public to come to you.
By taking this approach you will be well positioned for the inevitable demand for pay-for-performance models. In this case physicians and hospitals may receive a bundled payment for caring for a given number of people. Managing the risks of that population’s health is crucial to cutting costs and delivering quality care.
2. Identify the most important population health issues. Since most health care is provided locally about 80% of your patients will live or work within the geographic footprint of your facility. What’s more many employees will move between employers, so their data is best gathered and stored centrally by the hospital, instead of by a payer. However, the target populations that provide the data will usually come from groups in which the cost or selection of healthcare is provided or influenced by the organization. Knowing this, you should approach employers, churches, service groups and other organizations within your area that are aggregators of individuals.
Next you mustidentify population health concerns through data aggregation, which implies data gathering, storage and analysis. Make sure to stratify the data to profile and segment consumers by physician affiliation, insurance plan, family history and other health identifiers. It can also be used to monitor managed care purchasing decisions and to promote hospital service lines to patient populations. Armed with this data a hospital or health system would be well positioned for narrow networks
3. Align with payers that share your goals. This is not so difficult since many healthcare organizations and payers have adopted capitation models like HMO’s. These organizations already embrace the pay-for-performance model and recognize the need for a health management program. Additionally, many health care organizations have entered into the self-insured business model and are already taking their own pay-for-performance model to the market in the form of narrow or exclusive networks.
So, hospitals that reach out to non-profits and employers in the community can prove their worth in these partnerships and become a critical part of the accountable care equation. It will be clear by your progressive nature that you are the partner of choice in that geography. Just make certain in any arrangement that you own the data as that is how you will drive success.
4. Evangelize “population health management” as the future for both hospitals and physicians. Of course physicians are the source of almost all hospital admissions. Those referral relationships with area physicians are critical. As an extension of this key relationship many hospitals recognize that their role in a population health management program can be a way to bring new patients and value to their physician partners. For example many wellness programs create health evaluation events or screenings which is a great time for physicians to meet and create lifelong patient relationships. Physicians with a strong referral relationship or those employed by hospitals are likely to be more attune to the success of their hospital partner.
5. Utilize pre-primary care or wellness programs to manage population health. It’s no secret that our country faces serious health issues. Wellness programs and screenings have traditionally involved connecting with the community to get the hospital’s name in the market. Now more than ever they should serve to educate community members about healthy choices and create an ongoing primary care relationship. The traditional model of implementing screenings once a year or offering flu shots must evolve as they are not effective in building meaningful, long term relationships. If they were, we still wouldn’t see communities where 40% of the population does not have a primary care physician.
As we all know, improving patient health long-term involves meeting patients before they come into emergency rooms to address a catastrophic event or chronic condition. It involves meeting the patient where they are and proactively reaching out to them with health oriented solutions. It starts with education, but to make education work you have to make it personal and practical. On-site “lunch and learns” and offering special sessions on chronic condition prevention and management are great ways to start.
Hospitals that understand their evolving role as the nucleus of an accountable care delivery model will reap rewards down the road – in addressing their mission to the community and in being more competitive in their marketplace.