Population Health Management: What the Health?

by Mary Sirois on Dec 7, 2017

AdobeStock_65704664.jpegThe following content has been reposted with permission from our channel partner, Pursuit Healthcare Advisors (view original).

Population Health Management (PHM)…three simple words, yet so much complexity. This blog will be the second of three to focus on the concept of PHM by looking at each element separately, this time we're focused on health. 

The  American Hospital Association, in their “2017 AHA Environmental Scan”, shared the following:

"Diseases from life-style induced conditions take the lives of more than seven in ten Americans…Research shows that achieving ‘six normal’ ranges (LDL, blood pressure, blood sugar, waist-to-height ratio, stress management, and tobacco toxins) with or without medication, reduces subsequent chronic disease by 80-90% over a 10-30 year period.”

But here’s the kicker…

“If only 65% of individuals achieved the 6-normals, the nation would save well over $600 BILLION in health care spending PER YEAR.  Currently only 3-4% of the US population entering Medicare meets those levels.” (Source)

So back to HEALTH. What does "healthy" mean to each individual person?  Clearly, a healthy state is different and easier to achieve for some than others.  Eat right, exercise, take your meds for what you can’t control, exercise, manage your stress, don’t smoke, and oh yeah...wear sunscreen. It’s an individual decision to be healthy, but some people simply need help.

The healthcare system needs to make it easier to be healthy.  The check-the-box method to indicate that smoking was addressed is not the answer.  Sharing data about medications, understanding the full scope of care across the organizational continuum and beyond, as well as understanding a patient’s social determinants of health, defined by the Kaiser Foundation is the key to changing behaviors and improving the health of populations.

Social Determinants of Health GraphicUsing data that is ALREADY AVAILABLE and understanding the impact of such on care solutions and approaches that will change a person’s behavior, promote a healthy lifestyle, and result in improved care, an engaged patient, and lower costs…THAT is the key to our success.

As I shared in my first blog, the challenge of interoperability across clinical and revenue cycle systems, add to the complexity of understanding the individual within a population and related HEALTH data.  This is where Pursuit can help, by bringing an understanding of the intersection of data and process together, along with supporting tools, to help organizations truly understand their data about populations. 

In addition to data and workflow challenges, organizations must evolve from a siloed, loosely governed population health effort to formal organizational alignment with both operational and medical staff leaders to use and share data across the continuum of care, for the good of the PATIENT and explore creative care models to address high-risk populations.  Pursuit has seasoned consultants available to help create strategic and operational plans that align leadership, technology, data and care models that will help organizations better address population health and be successful in the world of evolving reimbursement models.

The next blog will focus on the MANAGEMENT aspects of PHM, the organizational and cultural implications of managing care in a way that improves quality, reduces cost and engages the patient…all in preparation for organizational success in moving toward value-based care and ensuring organizations can continue to fulfill their missions.

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