The Definitive Guide To Population Health Management

Team Innovaccer
Fri 12 Jun 2020
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Healthcare is perhaps one of the largest sectors in the U.S. and has evolved from numerous points of view, with healthcare data rising to become its deep-rooted member. Despite the developed and specialized technical proficiency today, healthcare organizations are struggling with data irregularities, missing data, and legacy systems. The significant reason for these issues is the lack of knowledge about population trends. Population health management has developed from an idea to become a clinical discipline that works on consistently refining and developing measures to improve citizens’ health status. A thriving population health management program strives to deliver vigorous and coordinated care through a well-managed partnership network.  

What is Population Health Management?

Population Health Management (PHM) can be termed as the health outcomes and distribution of such outcomes within a group of individuals. Now, these groups can be either geographic populations such as communities, nations, or other groups, which includes ethnic groups, employees, disabled persons, and any other specified group.

Population health management aims to find methods to improve patient health outcomes and control overall costs and be considered essential in value-based care. The information gathered can help develop actionable steps of care treatment for the patient and fill patient care gaps. Care Management is a critical component of PHM and tends to revolve around improving medication management and patient self-management. 

However, the primary aim of population health management usually gets overlooked- it’s not delivering preferable care outcomes, it’s not containing costs. It’s regarding creating a surrounding where every patient receives safe, standardized, and high-quality care formed on their personalized data. A care setup cut out only for them. Population health management doesn’t simply need a new manner of thinking. It requires a new way of executing care setup combined with the pioneering skills- a seamless procedure of data exchange, on-hand data analytics, data-driven care coordination, dispersive workloads, and a radical, ever-growing focus on the quality of care.


The current scenario of population health management

Despite spending a significant amount on healthcare, the U.S. has worse health outcomes and a lower life expectancy than any other high-income nation as per the 2015 study from the Commonwealth Fund. Of the countries covered in the study, the U.S. performed equally poor for chronic conditions such as diabetes and had the lowest life expectancy at birth - 78.8 years. The U.S. ranks 27th in the world for its level of healthcare. The U.S. has not been applying public health concepts to chronic disease management and in understanding patterns of risk for such patients. Other countries with better health outcomes are doing by spending a comparatively lesser amount on healthcare.

Why is Population Health Management Important?

Population health management doesn’t need a new way of thinking. It requires a new approach towards executing care plans combined with artistic skills. A seamless method of data exchange, on-hand data analytics, data-driven care coordination, distributed workloads, and an intensive ever-growing pivot on the quality of care. In the current healthcare scenario, patient engagement is like medicine, which is to be prescribed to every patient as well as the provider. Changing the whole nation’s healthcare ideology to a single patient-centric approach is difficult, but this transition is necessary. It is unfeasible to understand engaged patients without a deliberate approach covering the overall domain of healthcare. Patients serve as vital drivers in the improvement of the whole picture and are an integral part of healthcare. Engaging patients to improve their health is a must not only for them but for enhancing the entire population’s health in the long run. Healthcare organizations are trying to increase the patient experience of care management and deliver quality at each stage. And the vast amount of healthcare can work as an unusual approach for innovation to boost patient engagement. A patient can receive care from various facilities- even within a network.  

The idea of care management has been established within the healthcare area for years. With the boom of value-based incentives and risk-based contracting, healthcare providers have shifted their pivot on enhancing outcomes and ensuring patients get the right care at the proper time. Value-based reimbursement models encourage providers to give better care and offer rewards for upgrades in results, efficiency, and wellbeing in an evidence-based totally, cost-effective manner. Effective care management is a valuable aid that specializes in patient-centric care and generates a quantifiable ROI to make contributions to a healthcare system’s bottom line.

The care teams perform an essential role in engaging patients through regular follow-ups. Lack of personalization, irregular and fragmented workflows of care managers would possibly lead to the generation of ineffective care plans for the patients. Reduction in patient engagement may be the result of the underutilization of technologies to research the large amount of patient information that care managers have at their disposal. Through building additional personalized care plans, patients are often engaged at a grass-roots level.


The future of population health management

Many healthcare organizations are moving towards including health IT products such as EHR modules and integrated population health management platforms, which help deliver analytics required to take necessary care management steps. Patients must also be actively engaged in their population health management programs. Effective chronic disease management needs patients to understand their condition and how they can be controlled and maintain consistent contact with care managers.

Care Management adds to Population Health Management in some ways. End-to-end care management, without a doubt, has an essential impact on patients having more than one medical condition. Health systems and organizations have begun to revamp their care management programs that address the difficulties patients face and make care delivery a better experience for them. Population health management is solely concerned with providing clinical and financial outcomes, and it’s impracticable without effective care management. Providers ought to aim to work towards that and leverage all the tools at their disposal to coordinate the care of patients and improve their lives, one patient at a time. An entire care management model is what healthcare providers should use to boost the healthcare industry and population health as a whole and procure higher outcomes at a lower value, driven by value.

Population health management tools and solutions

To facilitate population health management, some organizations use specialized applications that connect a population-wide electronic record with automated messaging to patients as per the resulting analytics. The purpose is to collect the latest data on various factors such as medications, problems, lab results of patients and services provided, and the date of services. Applying a set of clinical protocols to the record can determine which patients are overdue for particular types of preventive and chronic care. When automation software detects patients who need service in terms of care management, it can automatically send out a call, email, or text message urging them to make an appointment with their health providers.

Innovaccer being customer-centric healthcare IT organization, aims at providing the best care to its customers. Our one such product that covers all the aspects of Population Health Management is InGraph. It is the most intuitive healthcare analytics offering for population management health strategies for better health outcomes.

To know more about how you can get real-time access to analyzed data, and improve care coordination, schedule a demo of our population health management solution.


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Tags: Population health management, value-based care, payers
Team Innovaccer
The Definitive Guide To Population Health Management

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