Are Healthcare Organizations Prepared for Population Health?

Share Article

A new independent HealthLeaders Media report, Population Health: Are You as Ready as You Think You Are?, supported by McKesson, explores how leading healthcare organizations are making progress in population health, including care redesign, collaboration, risk-sharing, and population targeting. The report includes data from a survey of the 7,400-member HealthLeaders Media Council, along with a new segmentation tool that allows access to specific data based on setting, revenue, and more.

Population analytics is moving to the forefront as healthcare leaders embark on their population journey,” says Rose Higgins, Senior Vice President and General Manager for Population and Risk Management for McKesson

The evolution of population health is moving faster than many in the industry predicted. With 80% of surveyed healthcare leaders responding that they are underway with a population health program, it seems that the majority perceived they are equipping themselves for the shift. But with a variety of care management and payment methodologies to choose from, there is no magic pill to ensure this initiative’s success.

A new independent HealthLeaders Media report, Population Health: Are You as Ready as You Think You Are?, supported by McKesson, explores how leading healthcare organizations are making progress in population health, including care redesign, collaboration, risk-sharing, and population targeting. The report includes data from a survey of the 7,400-member HealthLeaders Media Council, along with a new segmentation tool that allows access to specific data based on setting, revenue, and more. The free version can be downloaded at http://www.healthleadersmedia.com/intelligence.

“Population analytics is moving to the forefront as healthcare leaders embark on their population journey,” says Rose Higgins, Senior Vice President and General Manager for Population and Risk Management for McKesson, “but it’s the ability to turn those analytics into action that can help providers impact patient behaviors to improve clinical outcomes while prospering in a value-based care environment.”

Understanding that data is key to population health management, organizations are investing in patient registries (57%), data warehouses (55%), analytics with population data (57%), and analytics with payer claims data (53%). But despite their increased commitment to making data-driven decisions, only 10% of respondents have actuaries on staff to support risk assessment, while 29% use actuarial consultants.

“To make a larger investment [in population health management], you’re going to have to determine not only what your care model looks like, but also what your risk or contracting model looks like,” says Amy Frankowski, MD, chief network integration officer for Mercy Health and advisor for this report. “Actuaries would have the skills to help you make that next step forward and determine whether you can take on more risk.”

The survey reveals that, as they build their competencies, organizations do seem willing to assume more risk. Shared savings programs with payers have become the most popular financial risk structure, cited by 50% of healthcare leaders. Other arrangements expected to grow within three years include shared profit and loss with payers (to be used by an additional 38%), direct contracting with employees (25%), and joint ventures with health insurance companies (21%).

There are a portion of organizations (31%) that are still getting their proverbial feet wet, trying to glean lessons from pilot programs before committing resources to population health management. The challenge there is that early and small programs may never be financially viable.

“In the short term, some of these interventions would be more costly in 2013, 2014, 2015, for rewards that you might see farther on down the road,” says Frankowski. “But fewer patient interventions in the short term isn’t necessarily going to mean lower costs down the road. You may actually need to have more interventions and spend more money today so that you’re not spending more money tomorrow.”

Population health management is seen as a model that supports cost control and efficient care delivery, thereby changing the role of hospitals and increasing the importance of care managers.

“Most of patients’ lives are not spent in [hospital] facilities,” says Gregory A. Spencer, MD,
FACP, chief medical officer and chief medical information officer for Crystal Run Healthcare. “Over time they are mostly at home, occasionally in doctors’ offices and, hopefully, rarely, in acute care facilities. We are beginning to see the hospital as just a different site of care.”

The care delivery system must adjust to this shift. 30% of survey respondents cite aligning care goals and incentives across the continuum as their top care redesign-related activity over the next three years. This will include redefining goals and incentives for primary care physicians.

“Compensation will have to be based on risk-adjusted panel size, performance on quality metrics, and some element of productivity.” says report advisor Timothy Ferris, MD, MPH, senior vice president of population health management for Boston-based Partners HealthCare. “Some form of those three are in all the contracts. If you’re a primary care doctor employed within an ACO, then moving to risk-adjusted panel size, quality metrics, and an RVU target is fairly straightforward because the employer can just create the terms for doing that.”

Other compelling statistics from the report include:

  • Nearly half (45%) of all organizations hold individual physicians or groups of physicians responsible for a panel of patients, and nearly half (45%) use team-based care.
  • Organizations are preparing for risk through patient-centered medical homes (60%), clinically integrated networks (56%), and ACOs (44%).
  • Patient engagement will become more important to track, with telehealth (34%), remote monitoring (31%), and systems to assess engagement (30%) among the top future investments.
  • The top areas for investments to improve access to care are midlevels/NPs/PAs (74%), patient engagement programs (66%), and outreach for wellness (60%).
  • Organizations are turning to familiar strategies for care redesign for population health: PCMH (55%), organizing care by disease state (51%), and risk-based panels (51%) top the list.

About HealthLeaders Media
HealthLeaders Media, a division of BLR, is a leading multi-platform media company dedicated to meeting the business information needs of healthcare executives and professionals. As an integrated media company, HealthLeaders Media includes HealthLeaders magazine, HealthLeadersMedia.com, the HealthLeaders Media Intelligence Unit, HealthLeaders Media LIVE events, and California HealthFax. All these platforms may be found online at http://www.healthleadersmedia.com.

About McKesson Corporation
McKesson Corporation, currently ranked 15th on the FORTUNE 500, is a healthcare services and information technology company dedicated to making the business of healthcare run better. We partner with payers, hospitals, physician offices, pharmacies, pharmaceutical companies and others across the spectrum of care to build healthier organizations that deliver better care to patients in every setting. McKesson helps its customers improve their financial, operational, and clinical performance with solutions that include pharmaceutical and medical-surgical supply management, healthcare information technology, and business and clinical services. For more information, visit us at http://www.mckesson.com.

Share article on socal media or email:

View article via:

Pdf Print

Contact Author

Amy Wieman
Visit website