Population Health Management Requires Dynamic Planning

Population Health Management Requires Dynamic PlanningMarch 5, 2015 by Vickie Anenberg

Population Health Management (PHM) is fast becoming the one of the most important factors affecting the long-term financial health of hospitals for the foreseeable future. Every PHM plan involves making complex decisions concerning such topics as the evolving changes in reimbursement, risk management, IT enhancements, and an aging population. Therefore, such plans must be dynamic to enable change as the PHM environment itself evolves.

With all there is to consider, the best approach could be to simplify the challenges so a clear picture of the issues emerges. One critical consideration was made plain in a new blog for Healthcare Informatics posted by Pete Rivera, who serves as the director of informatics for Hayes Management Consulting.

Rivera wrote, “We get so caught up in our day-to-day work that we often forget what it is all about. We focus on the technology and clinical side of Population Health, but there is another aspect that is harder to control: Patient Compliance.”

He concluded his blog by noting, “Population Health will be tracking various provider metrics, and could reflect if a patient is consistently showing non-compliance with prescribed therapies. This has the benefit of identifying those patients with certain special needs. These can include language barriers, help with navigating the healthcare system, or patients with transportation problems. There are also patients that can’t afford the deductibles or co-pays associated with therapeutic treatment or medications. Some patients are either too proud or too uncomfortable talking to the providers about these issues.”

The Advisory Board Company has been studying PHM for several years. In its original briefing paper, the organization divided successful PHM into three foundational segments:

In late February, Healthcare Finance posted a story about a new approach to PHM. Five Maryland health systems, consisting of 10 hospitals, announced they are forming the Advanced Health Collaborative to govern much of their PHM by leveraging state reimbursement.

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