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How population health management affects the healthcare industry

Population health management refers to the strategies used by the healthcare industry to improve population health. It’s the how.

To understand what population health management is and how it has impacted the healthcare industry, you first need to understand the term population health. As its name suggests, population health refers to the health of entire communities, not just individuals.

How is Population Health Different from Public Health?

Public health and population health are closely related disciplines. The difference largely has to do with scope.

Public health relies on partnerships between the public and private sectors. It uses policy recommendations, research, and community education and outreach to create conditions that protect and improve the health of entire populations.

Population health, on the other hand, relies on cooperation between health systems and between the different departments within health systems to identify lapses in care and improve care.

What is Population Health Management?

Though the need to provide better care at a lower cost had been clear in the healthcare industry for some time, a formal definition of population health management came in a 2003 paper in which David Kindig and Greg Stoddart proposed that the field of population health include:

  • Health outcomes
  • Patterns of health determinants
  • Policies and interventions that link these two

In short, population health management refers to the strategies used by the healthcare industry to improve population health. It’s the how.

The benefits of population health management include:

  • Ability to spot care gaps in the patient population
  • Better patient outcomes
  • Reduced cost of care for patient and healthcare providers
  • Better disease management for chronic conditions
  • Lower readmission rate

How has Population Health Management Affected the Healthcare Industry?

It’s well known that the United States spends more on healthcare than any other high-income nation in the world while delivering worse health outcomes and lower life expectancy. It’s this fundamental problem that population health management aims to solve. The ultimate goal is to improve the quality of care while reducing costs.

As a result, in a relatively short period of time, population health management has become a required competency for health systems. Administrators must now give their staff the tools to create a complete picture of the population they are caring for.

The bedrock of population health management is aggregating and analyzing clinical, operational, and financial data from across the health system. This data includes everything from physician bills and pharmacy costs to electronic health records and medical claims.

The most important area this data is put to use is in managing chronic diseases like diabetes, heart conditions and obesity.

Key Strategies Employed by Healthcare Businesses

Data Integration

The first step in any population health management strategy is integrating data. Data is the fundamental building block of any public health management strategy. Health systems today must be able to integrate various internal and external data sources to get an accurate picture of the patient’s current state and their journey throughout the health system, from intake to outcome. Data integration is about delivering the transparency that is used to manage risks and identify opportunities for improvement.

Analytics

Analytics is the second key component of population health management. Once a health system has the data to identify risks and opportunities, it needs a system to analyze that data in order to develop an understanding of the population, target the right people in that population for interventions, identify improvement opportunities, and understand the total cost of care across departments. Analytics are also necessary to ensure that initiatives are having the intended impact.

Value-Based Care

At the center of population health management is cost. One way of incorporating cost into the DNA of how care is delivered is by switching to a value-based care model. Value-based care is a system of reimbursement that rewards providers based on the quality of care they provide. At the core of a value-based system is the ability to understand the total cost of care and to ensure the payment system is set up to deliver adequate compensation for services provided.

Evidence-Based Care

With proper data and analytics capabilities, health systems can begin responding to care gaps in real-time. Weak spots in the continuum of care can be identified and rectified. This is called evidence-based care. One common use of evidence-based care is to strengthen the primary care infrastructure to preclude higher-cost interventions.

Current Trends in Population Health Management

Overhaul of Opioid Prescribing and Treatment Practices

The opioid epidemic is one of the worst public health crises in recent memory. 70,000 Americans died of opioid overdoses in 2017 alone. The response by health systems has been to overhaul prescribing practices as well as to work with public health officials, payers, community organizations, and pharmacies to reduce opioid abuse.

Wearable Health Technology

The use of wearable technology, like smartwatches, has skyrocketed in recent years, and population health management professionals have taken notice. The most basic devices track key health metrics like heart rate, exercise, and sleep rates. More advanced devices monitor blood pressure and respiration rates. Health systems are working to get permission from patients to use these devices so they can collect, organize and analyze this important data.

Vaccine Outreach

It’s said that one ounce of prevention is worth a pound of cure. Nowhere is that more true than in the realm of vaccinations. Health systems are working to increase vaccine rates by identifying, targeting, and connecting with under-immunized populations. By increasing the number of patients that receive a flu shot, for example, they can reduce the number of patients visiting the emergency room. Less than half the adult population in the 2018-2019 flu season got flu shots.

Community Partnerships

It’s estimated that 80 percent of health determinants occur outside the realm of healthcare. Things like transportation access, employment opportunities, housing security, and access to grocery stores have a huge impact on a population’s health. In other words, the most powerful determinants for a person’s health have nothing to do with what doctor they see or what interventions that doctor initiates. That’s why a key part of many population health management plans now include partnerships with community organizations that are working to alleviate patient populations’ socio-economic burdens.

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