Payers are beginning to tell physicians that they must look outside the walls of their practices, and shift their focus from caring for individual patients to caring for whole populations of patients as part of value-based care initiatives. This new approach brings many new pressures: to communicate better with patients and caregivers; to dedicate additional staff to manage patients with chronic disease; and to incorporate new technology.
Population health management (PHM) is the new phraseology that defines the efforts of a single practice or a larger group like a clinically integrated network (CIN) to provide patient services like timely health screenings, cost-effective treatments, nutritional counseling, and staff interventions to keep a patient population healthy and reduce the consumption of healthcare services. But that could be a tall order for a small practice with only a few physicians and limited staff. Fortunately, it is possible to build a PHM program starting with small incremental steps. We asked our experts how to get started, and here's what they said.
Karen Handmaker, vice president of population health strategies for technology company Phytel (a subsidiary of IBM Watson Health), says managing population health involves directing an organization's efforts toward quality-care initiatives like the Institute for Healthcare Improvement's Triple Aim, which strives to reduce the cost of healthcare while improving the patient experience and the health of whole populations. "[The Triple Aim] derives from value, and that is what the whole population health management and value-based payment is built upon," she says.
It may be disheartening for small practices as they consider the cost and investment of time and staff that population health often requires. Large health systems can have vast IT departments at their disposal, an army of community outreach professionals, and more money to fund population health programs. But according to Susan Corneliuson, Washington-based senior manager with consulting firm GE Healthcare Camden Group, joining forces with other physicians via an independent physician association (IPA) or a CIN is an easy way to multiply resources and potentially boost access to more robust technology systems.
Physicians join associations like an IPA or CIN primarily to work together with other physicians and groups or hospital systems to improve the care of their patients and reduce costs through strategies such as economies of scale and care utilization. They are also able to benefit from contracting together with larger service entities and/or payers.