Although one of the often used terms in the healthcare industry; population health management is also one of the least understood. The industry uses the term to cover everything from big data analytics projects to basic team-based care initiatives. However, in order to implement the Triple Aim, healthcare organizations and professionals need to know and understand population health management.
What is population health management?
The basics of population health management involves the process of establishing patient cohorts based on identified characteristics and for each of these groups developing tailored preventative and acute care protocols. This leads to finally treating patients according to their risk profiles. Healthcare providers dealing with population health management must ensure that standardized high quality care is provided to patients on a consistent basis – thus achieving optimal results.
More often than not, the outcomes are tied to financial reimbursements. Payers like Medicaid, Medicare and others generally identify goals for specific services or population segments and reimbursement rates are based on the provider’s ability to manage meeting these goals.
Benefits of population health management:
PHM possesses effective benefits aimed at patients, health care institutions, physicians, the entire system and overall nation as a whole.
Better Health Outcomes: PHM aims at improvement of healthcare quality, while reducing costs at the same time. For measuring this benefit, year wise admissions in hospitals and private healthcare institutions can be evaluated.
Disease Prevention: PHM abundantly takes care of patients who are facing chronic diseases involving high costs of treatment. PHM uses effective solutions for managing the care provided by healthcare service providers to these patients.
Reduction of Care Gaps: PHM provides ample amenities to physicians and organizations to access patients’ needs in real time and generate help as fast as they can. Hospital bills, laboratory data, health record and prescriptions are taken into consideration due to which unmet needs of patients can be addressed and served. Thus service delivery gaps can be eradicated positively.
For the Patients: No doubt, better coordinated care is received by patients and they enjoy improved health. This is because they are notified of the medication process that is required for managing their diseases. Timely care provided to patients ensures that huge costs pertaining to extraneous expensive processes are saved.
For Physicians: Physicians get better information and more chances for engaging in curing process, thus resulting in absolute better outcomes. Physicians are made to provide satisfactory health services by focusing more on patients’ engagements and timely, synchronized and suitable care.
For Health Care Institutions: These organizations are in the profitable side irrespective of the payment models that they follow. This is because, care gaps are fundamentally lessened, volume of patients improved and the care costs can be specifically quantified.
For the Health care system: The system receives maximum benefits due to enhanced preventative care that helps in avoiding expensive treatment processes. This simultaneously leads to higher service quality, benefitting the entire system as a whole.
For the Nation: The benefits received by the above entities get accumulated in the health of the national population as a whole. Reduction in costs, better disease handling and in general a population with better health conditions are the ultimate positive outcomes for a nation.
- Christopher Tompkins, A. H. (2013, April 02). Population Health Management In Medicare Advantage. Retrieved December 06, 2016, from www.healthaffairs.org: http://healthaffairs.org/blog/2013/04/02/population-health-management-in-medicare-advantage/
- Suiter, P. (2015, February 23). Financial Benefits of Population Health 2.0. Retrieved December 06, 2016, from www.aegisgroup.com: http://www.aegisgroup.com/financial-benefits-population-health-2-0/
- Tas, J. (2016). Population health management: the barriers, benefits and bridges. Retrieved December 06, 2016, from www.philips.com: http://www.philips.com/a-w/innovationmatters/blog/population_health_management.html
- Wellness 360 — Confidence with Wellness & Population Health Management. (2016). Retrieved December 06, 2016, from www.benefitadvisorsnetwork.com: http://benefitadvisorsnetwork.com/services/wellness-population-health-management
- What is population health management? (2016). Retrieved December 06, 2016, from www.athenahealth.com: http://www.athenahealth.com/knowledge-hub/population-health/what-is-population-health-management