Though you’d be hard-pressed to find a consensus on the definition of this term, most experts agree on a pretty clear explanation. “Population health management is the proactive application of strategies and interventions to a defined group of individuals in order to improve the health of those in the group at the lowest cost,” offers health care executive Joe Welfeld.
Based on this definition, you can see that there are a few primary goals. The first is to yield a healthier population. The second is to reduce the overall cost of care. This should also help drive efficiency. It sounds simple enough, so you might wonder why you stumble across so many definitions that say something different. According to Todd DeWeese, Vice President of Population Health Management Consulting at Premier, a lot of this has to do with the sheer volume of companies trying to thrive in a competitive market.
“Population health gets confusing because it’s a name being used by a lot of vendors and service companies that want to work with or provide solutions to hospital systems, large physician groups, and insurance companies,” he says.
Some people have a tendency to confuse population health management with value-based care. They’re related, but actually quite different. The second term is a compensation model that pays providers based on successful outcomes rather than the number of services provided.
HOW DOES POPULATION HEALTH MANAGEMENT WORK?
It’s obviously appealing to help improve the health of a large group of people. But how do you actually do that? It starts with targeting a specific population.
“Most health systems look at people within a defined geographic area,” DeWeese explains. “What they then try to do is look at the specific diseases that those people have a propensity to develop throughout their life, starting with pediatrics and going all the way through geriatrics.” He also notes that this differs from one region to another.
The next step is to segment that population into different groups based on their risk for developing those health issues. In the most basic sense, you would identify individuals who already have a diagnosis and those who are likely to have those same issues later on. This requires data analysis.
“You have to mine various databases, usually from claims information and clinical information in electronic medical records,” DeWeese explains.
IS POPULATION HEALTH MANAGEMENT POSSIBLE?
Achieving both lower costs and better health outcomes simultaneously would obviously be a win-win scenario. Whether population health management is actually feasible is up for debate, though. One major obstacle is that information isn’t standardized.
“The biggest issue is that of data analysis and ensuring the various electronic medical record systems have the ability to talk to each other and share data,” Welfeld offers. “Unless data can be aggregated, using it for population health management is a pipe dream.”
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