Population Health Management: Patients first

Population Health Management (PHM) is (as stated by Wikipedia) “the health outcomes of a group of individuals, including the distribution of such outcomes within the group”. This is an an approach to health that’s focus is to improve the health of an entire population.

PHM has several aims that will help with the challenges presented by healthcare reform such as keeping the healthy as well as possible through preventative care, and preventing the chronically ill from getting sicker and therefore reducing costs through fewer encounters with physicians.  In terms of collaborative care, PHM has a lot to offer, such as predictive modeling, health risk assessments  health information technology infrastructure, analytics & care coordination and other core competencies.

Though as accountable care organizations become a reality,  they should be structured in a way that provides an incentive for managing health where there could be an opportunity and not just be 21st century versions of HMOs. In addition, as population management studies rely on a multi-year reference as a baseline and so when the codes change to ICD-10 this October 1st, 2014, it will be difficult to manage or translate from the previous baseline and collect any valuable data and there will be a few years before healthcare organizations can again start tracking meaningful population health management trends with ICD-10.

According to a December 2011 article in Healthcare IT News, it mentioned that “population health management has been both a driver and benefactor of the rise in eHealth and mHealth technologies”. As we move into an ever more mobile world and demand has risen for mobility solutions in everyday life such as music, news and navigation, mobile technology in patient engagement has been ever more utilized and can be of immense use by care delivery organizations for population health studies. Through a more proactive, integrated approach to population health management, clinical costs could decrease and provider organizations could maximize their reimbursements for a good delivery of care to their patient population.

In reviewing CMS’ quality strategy, it appears that it aims to efficient, patient centered and timely care that is equitable and focused on reducing health disparities. In order to prepare for the upcoming demands of population health management and to comply with clinical data elements, clinicians and hospitals should try to leverage ICD-10 information and clinical information and build analytical capabilities that could assist the operations and clinicians where to focus their attention. This will be the opportunity for what is called Big Data to show it’s usefulness in clinical care in the months and years following October 1st, 2014 in order to support federally mandated reporting needs. Ultimately though, the theme continues to be “patients come first”.


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