Sunday, March 8, 2015

Of Population Health Management and Health Reform Innovations

In a prior post, the Disease Management Care Blog highlighted the Aspen Institute's recommendations for health information technology. The Aspen report also dealt with other areas of innovation but neglected to consider how population health management can help.

Surprised that something so obvious could be forgotten by experts holding forth in Washington D.C? The Renault-esque DMCB says it is shocked, SHOCKED.

Fortunately for them, the DMCB has recovered and can step forward to fill in the intellectual gaps.  The Aspen recommendations are bolded and the potential role of population health management is italicized.

Global payment strategies should include risk adjustment, legal safe harbors and risk mitigation: What's often lost in the calculus of health reform are the up-front investments and potential downstream losses once provider organizations wander away from fee-for-service into global payment arrangements.  The good news is that population health management service companies have had two decades to learn "risk mitigation" and are an important option as FFS goes away. 

Explicit financial support of innovation is necessary so that if efficiencies are discovered, there is no penalty: One ingredient in the successful transition from Ver. 1.0 "disease management" to Ver. 2.0 "population health management" was innovation.  Near death experiences have a way of promoting change.  Provider organizations that ignore those insights do so at their peril.

Disseminate "systems" experts and engineers in the delivery system: Attend the upcoming Care Continuum Alliance meeting this fall in Atlanta and you'll get to meet some.  Really.

Help small practices achieve economies of scale and take advantage of the experts mentioned above:  "Bravo!" says the DMCB because Aspen has recognized that, despite the earnest wishes of naive health reformists everywhere, a huge proportion of U.S. health care will still be provided by smaller physician-owned groups for years to come.  Population health management service providers know that and can be one ingredient in tying them all together without forcing them into unwilling networks.

Interoperable health information technology should not only allow clinical data liquidity, but foster transparency and accountability: There's the EHR, there's the health information exchange, there are health insurance claims databases and then there is the information resident in the systems of population health management service providers.  Not only is that raw data useful today, these outfits can also leverage all that information with predictive modeling that identifies the patients at greatest risk.

There should be stronger link between quality improvement and health policy: Aspen correctly says there should be strong links between the theoretical and real world.  Actuaries span both worlds.  So does population health management. 

Make performance, safety and cost data transparent and relevant: While there is something to be said for making slicker web sites that pack Consumer Reports-like information, the ultimate purpose of population health management is to make performance, safety and costs personally transparent and relevant.

Increase health literacy by starting in our nation's schools, like those home economics classes: While we wait for school districts to get that up to speed, we need to do something for the adults.

Enhance consumer trust by increasing communication and helping patients understand that they are allowed to ask questions and "own" their records: One commonality in patient coaching, motivational interviewing and shared decision making of population health management is empowerment. 'Nuff said.

Increase the translation of research findings by having neutral intermediaries report new findings for public consumption: the DMCB cannot disagree and has recommended that population health management service providers learn how to refer patients to trustworthy on-line patient communities.

Increase the use of mobile apps: Come to think of it, the Disease Management Care Blog needs to add to it's cool persona with an "app."

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