Six Essential Steps to a Successful Population Health Management Program
As hospitals seek ways to reduce overall healthcare costs and create healthier communities, Population Health Management (PHM) is becoming central to thesolution. Aegis Health Group, drawing on more than 20 years of experience in working with hospitals, has identified six essential steps to a successful PHM program:
1. Create a broad network of partners. Hospitals must first obtain overriding support and cooperation from within and outside the organization. This includes the management team, medical staff and referring providers as well as
community organizations and leaders.
2. Hone your PHM focus. Identify the health improvement components that wil lprovide the greatest return investment for the hospital, providers and the community at large. Key areas of focus will be identified based on data collection and analysis of market demographics and psychographics(lifestyle,behaviors and values), hospital service line capacities, and provider and payer profiles. Special emphasis should be placed on pinpointing the population health issues that are most costly and that put the greatest strain on provider resources.
3. Develop key payer relationships. Hospitals must be prepared as more payers migrate toward reimbursement models that incentivize coordinated quality care through shared savings and seek to curb demand for critical and acute care for servicesthroughbundled payments. Hospitals must align themselves with payers who share not only their strategic goals of improving the health of the population and reducing the per capita costs of healthcare,but their clinical goals to enhance the experience of care and their financial goals for a sustainable reimbursement strategy.
4. Foster strong physician relationships. By Its very nature a PHM program will identify health risks of the population as well as determine who doesn’t have aprimary care physician. The key to effectively managing health risks and improving overall health is to have an aligned and supportive physician community.PHM is a win-win for hospitals and Physicians as it is simultaneously identifying and mitigating healthrisks·while building referrals to affiliated physicians.
5. Collect, analyze and track data to monitor health improvements. With optimal data and resultst racking,hospitals can measure whether individuals are using more appropriate and less costly services,as compared to postponing care untilmore acute care is required. A robust PHM program includes the tools that allow hospitals to do this.
6. Offer community education, outreach and interventions to mitigate health risks. Comprehensive and coordinated preventive or “preliminary care” is the most meaningful way to affect key health cost drivers within a community. Led by hospitals these programs would operate from the premise tha tit is less costly to engage patients in health improvement before they develop risk factors instead of waiting for patients to require primary care interventions or acute-care treatment.
“With a solid population health management program, hospitals can make apositive and significant impact on the
health of the entire community while creating a stronger and more financially sound healthcare re-organization, said Pearson Talbert, president of AegisHealth Group.