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The Importance of Population Health Management Programs

In recent times, healthcare organizations and providers have discovered that it is more cost effective to engage in preventive healthcare than treatment. Hence Population Health Management Programs and other similar programmes are becoming increasingly popular.

Population Health Management Programs

Population health management involves collating the health data of members in a group and using this data to identify at-risk individuals, and craft best healthcare practices in a way that reduces costs and improves quality of care. The goals that population health management sets to achieve is known as the ‘Triple Aim’ which are:

**Improving patient experience
**Reducing per capita costs
**Improving the health of the population

But how can health providers start the implementation of this new approach to patient care?


Implementing Population Health Management Programs


Population Health Management Programs

The process of implementing a successful population health management program may seem pretty straightforward in theory, but in reality requires careful planning and execution which if not meticulously carried out, may defeat the purpose of the program.

The most crucial step involves gathering critical demographic and clinical data about patients assigned to a provider. Patients may be decided on a variety of basis which may include geographical areas, employer, health insurance provider, or diagnoses. The patients are then sorted into categories based on their clinical history and risk.

Typically, population health management programs require an analytics tool to collate data and provide a detailed clinical picture of each patient. Investments in data analytics and population health technologies are therefore essential.



Tools for Implementing Population Health Management Programs

Population Health Management Programs

The analytics tool can be as simple as Excel or as advanced as a population health module that has been specifically designed to link various local health information. There are a number of IT solutions companies that offer technology for this purpose and for organizations ready to take this step, the options are limitless. Many health IT developers are offering risk stratification and tools for clinical support that are driven by cutting edge technology. Organizations would have to invest heavily in data analytics and population health technologies, cultivate innovative skill sets, including team-based approaches to distributing workloads, familiarity with the data analytics tools and a thorough knowledge of quality reporting and proper documentation.
Depending on the size of the organization, a dedicated team of data scientists and health informaticists may be required. Snagging a data scientist with a clinical background will be an added advantage to the team. There’s so much the data can’t tell you, that’s why clinician’s need to have an inherent knowledge of how the data translates to care These data governance experts can break down barriers between providers and enable them access one another’s demographic, socioeconomic, or clinical data to map out strategies for improved patient care.


Different Population Health Management Programs

From data collected, a care program can now be decided for the patient. Programs can either be reactive, proactive or a combination of both depending on the condition.

Reactive programs are usually employed for patients with terminal diseases, or diseases which have no cure but can only be managed such as diabetes or cancer. By comparing current treatment trends across the care continuum using data provided, the health care providers can decide the best course of treatment that would be beneficial to the patient at the lowest cost.

For proactive programs, the use of predictive analytics is employed to effectively identify patients who would benefit from medical interventions which would, in turn, lead to improved outcomes.

From the data collected, each patient is assessed and given a risk score. Patients with higher risk scores may require more frequent follow-up and attention, social support, medication adherence advice or even suggestions to enroll in patient support group programs —for example, a hypertensive patient with a family history of heart disease. The primary care provider, using the analytics tool can be able to identify the risk of the patient developing heart disease and also outline a care plan to help prevent it.

This method of preventive care is intended to maintain the highest health status of a patient, reduce the chances of preventable hospitalizations and improved the overall quality of life.

Providers are expected to report on all their activities; how often they conduct routine screenings and investigations, how well they adjust to specific treatment guidelines, whether or not their efforts are producing the right results. Those that perform well may receive value-based financial reward from the insurance company of the patients or the government in charge of health care. This is because these companies save a ton of money off interventions and plans which prevent future hospitalizations and increase the quality of life of the patients. These financial incentives are usually the most effective in driving improvements across the care continuum, encouraging a collaborative environment of safe and standard high-quality care based on personalized data for each patient.

To develop a successful health management program, healthcare organizations will need to change their traditional mentality that believes that more patient volume equals more revenue. As stated earlier, one of the aims of population health management is improving patient health which means keeping patients away from the hospital. This is why providers need to familiarize themselves with available savings programs to enable them to benefit from the reimbursements that come from effective health management programs.

Organizations will need to report on quality and performance to external organizations. This may seem cumbersome, but it’s an important part of understanding how to improve. Keeping tabs on how well clinicians are adapting to new programs and requirements is important.
Conducting regular surveys on patient satisfaction, taking out time to understand any provider workflow concerns can help to easily smooth out patches that may arise in the course of the transformational effort. A thriving population, health management program, is one that encourages collaboration between the clinician, health care provider and patient because of any of the involved party is dissatisfied, then it defeats the purpose.


Conclusion on Population Health Management Programs


Setting up a population management program is no walk in the park.  There are plenty of pain points such as financial constraints, inability to adequately interpret data, insufficient or inexperienced staff and many more. The process may also seem daunting and capital intensive. However, once the initial hurdles have been overcome and the program is underway, it becomes clear that at the end of the day, the amount of money, time and lives saved from the program far outweighs the cost of its setup.

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