In this recent Becker’s Hospital Review article, I found it notable that so many of the top 10 challenges and opportunities for hospitals in 2015 were related to population health management. In addition to population health, which was called out on its own, five other related trends included the shift to value-based reimbursement, M&A, system integration, the use of data, and the need to lower costs due to reimbursement rate differences. To that list, I would also add clinical integration and quality improvement as two other top challenges hospitals are facing. It’s interesting that while providers have a variety of challenges that fall into different buckets, population health is a single strategy that can help address them all.
Some providers are taking a conservative approach with population health because it is still so new, and they are trying to determine the best way to proceed. However, we’re starting to see more providers view population health as a strategy that is central to solving many of the biggest challenges they are facing. Those providers have already begun building their population health capabilities because they view them as requirements to achieve their overall long term strategy, which often falls into one or more of these broad categories:
Growth – providers seeking growth via acquisition, clinical integration, partnerships or the signing of new commercial contracts
Quality – providers that make quality their organizational focus and want to differentiate on it
Raise Margins/Lower costs – providers seeking to strengthen long-term financial performance by lowering costs and benefiting from risk-based contracts
Efficiency – providers that want to improve clinical efficiency and achieve better coordinated and consistent care
Population health solutions bring a broad set of value to organizations that allows them to solve a variety of business challenges. The core capabilities of population health are:
- Data aggregation – merge and share all data from information systems across a health network
- Predictive analytics – understand clinical and financial risk of a population to identify opportunities for improvement
- Care coordination – improve coordination, efficiency and consistency of care in order to improve patient outcomes
- Patient engagement – empower patients in self-care to modify behaviors that can improve patient outcomes
One of the most valuable aspects of these core capabilities is that they can be applied broadly. Providers can use them to address today’s initiatives, but can expand and evolve them as new challenges emerge in the future. Whether it’s integrating the health IT systems from an acquisition, lowering the cost of care for a population in an ACO, expanding a clinically integrated network, or lowering readmissions rates, population health solutions are needed. I’m predicting that 2015 is the year that population health shifts from being perceived as a new concept to a core strategy that providers will be employing to achieve long term success.