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Don’t let Population Health Demographic Trends Guide “Investment” Decisions

A Different Perspective on Population Health

By Dr. David Edward Marcinko MBA CMP®
http://www.CertifiedMedicalPlanner.org

Definition

Population health has been defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group”. It is an approach to health that aims to improve the health of an entire human population or cohort. http://www.HealthDictionarySeries.org

History

In fact, the nominal “father of population health” is colleague and Dean David B. Nash MD MBA of Jefferson Medical School in Philadelphia. And, although I attended Temple University down the street, David still wrote the Foreword to my textbook years later; Financial Management Strategies for Hospitals and Healthcare Organizations [Tools, Techniques, Checklists and Case Studies].

Factors

Now age, income, location, race, gender  and education are just a few characteristics that differentiate the world’s population. These are called ”disparities” and they have a major impact on people’s lives; especially their healthcare. And, I’ve written about them before.  Perform a ME-P “search” for more.

So, it’s only natural that we’re keeping an eye on two major demographic trends: aging baby boomers and maturing Millennials [1982-2002 approximately].

Why it’s important

The impact of large population shifts propagate throughout an economy benefitting certain sectors more than others and influencing a country’s growth prospects; tantalizing investing ideas?

Example:

For example, as baby boomers retire, we’ll likely see higher spending on health care, but less on education and raising children. Likewise, tech-savvy Millennials will likely prioritize consumption on experiences over cars and houses [leading economic indicator].

So, can we profit from these trends?

Assessment

Well maybe – maybe not! Overall economic prospects may not be completely affected by these trends. Spending habits on combined goods and services will shift, rather than rise or decline.

So, be careful. What matters most for your investment success is your demographics and investing according to your personal circumstances and goals [paradox-of-thrift].

Conclusion

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What is Population Health?

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DEM white shirtBy David Edward Marcinko MBBS DPM MBA MEd

http://www.DavidEdwardMarcinko.com

What is population health?

In its most fundamental sense, population health seeks to improve or manage the health of a specific population. It is a systematic, holistic approach that aims to prevent disease by keeping people healthy and improving the quality of care.

HDS

http://www.HealthDictionarySeries.org

In fact, according to my colleague David B. Nash MD MBA, Founding Dean and Endowed Chair at the Jefferson College of Population Health, population health programs and interventions work to:

  • Connect prevention, wellness and behavioral health with traditional health care delivery
  • Focus on improving the quality and safety of care, improving access to healthcare services and helping to prevent/manage chronic diseases in the service of a specific population
  • Advance policies and solutions to address socio-economic and cultural factors (social determinants of health) that have an impact on health outcomes
  • Leverage technology and information systems to design social and community interventions and new models of health care delivery that facilitate care coordination and access

Conclusion

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The Hearst Health Prize for Excellence in Population Health

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Call for Applications

David NashBy David B. Nash, MD, MBA

[Dean, Jefferson College of Population Health]

Dear Colleagues:

We are excited to announce that we are now accepting applications for the Hearst Health Prize for Excellence in Population Health. The winner will receive a $100,000 cash prize in recognition of outstanding achievement in managing or improving population health.

Hearst Health Prize

The Hearst Health Prize, in partnership with the Jefferson College of Population Health (JCPH), was created to help identify and promote promising new ideas in the field that will help to improve health outcomes. Our goal is to discover, support and showcase the work of an individual, group, or institution that has successfully implemented a population health program or intervention that has made a measurable difference. image The competition is open to individuals, groups, organizations or institutions, except those employed JCPH, Hearst Corporation, or their respective affiliates.

For more details, click here. Finalists will be invited to present their project at a special poster session at the Population Health Colloquium in Philadelphia on March 7, 2016. The winner of the prize will be announced during the opening session of the Population Health Colloquium on March 8, 2016.

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Jefferson

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Assessment

Click here to apply or learn more about the Hearst Health Prize. The deadline to apply is October 23, 2015. If you have questions, please email HearstHealthPrize@jefferson.edu. We hope that you share this amazing opportunity with your colleagues!

More:

We are pleased that Dr. Nash wrote the Foreword to our newest book. Read it here: [Foreword Dr. Nash MD MBA FACP

Conclusion

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“Welcome to Health: Population 1” the PHA Forum

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[By staff reporters]

This years PHA Forum has The Great Debate during the Executive Institute between Al Lewis and Ron Goetzel on Wellness Programs and ROI, but the PHA Forum also has incredible keynotes, programming and networking.

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Read More: “Welcome to Health: Population 1” the PHA Forum

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Population Health Management Integration

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Of Medical and Pharmacy Benefits 

By http://www.MCOL.com

pop health

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How Using a ‘Scorecard’ Can Smooth Your Hospital’s Transition to a Population Health-Based Reimbursement Model

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Transforming Business and Operating Models

[By Russ Richmond MD]

Russ Richmond MDDr. Marcinko and ME-P,

The US healthcare system’s myriad of problems again seized the headlines recently with the release of an Institute of Medicine report, which found that 30 percent of healthcare spending in 2009 – around $750 billion – was wasted. Citing the “urgent need for a system-wide transformation,” the report blamed the lack of coordination at every point in the system for the massive amount of money wasted in healthcare each year.

One critical area in particular need of transformation is the business and operating model that drives healthcare in the US. There is broad-based agreement across the healthcare industry that the current fee-for-service model does not work, and needs to be changed. The sweeping health reform law enacted in 2010 included a range of more holistic, value-based payment structures that are now being referred to as “populatiobn health.”

Population health is an integrated care model that incentivizes the healthcare system to keep patients healthy, thus lowering costs and increasing quality. In this value-based healthcare approach, patient care is better coordinated and shared between different providers. Key population health models include:

  • Bundled/Episodic Payments – This is where provider groups are reimbursed based on an expected cost for a clinically defined episode of care.
  • Accountable Care Organizations (ACOs) – This new model ties provider reimbursement to quality and reduction in the total cost of care for a population of patients.

Both of these care approaches aim to reduce care utilization through prevention programs, case/disease management and integrated care coordination, including better information transfer across different providers. Equally important, they are focused on reducing the cost of treatment by managing physician misuse and overuse and driving volumes to lower cost settings of care.

The shift to coordinated care is rapidly picking up steam across the country. According to a recent American Hospital Association survey of hospital chief executives, some 98 percent of respondents agree that hospitals should investigate and implement population health management strategies. Anecdotally, the hospital leaders participating in the survey indicated that it is not “if” they will have to pursue these risk sharing strategies, but “when.”

Even with healthcare providers now realizing that migrating to a population health approach is inevitable, there is still significant confusion about the crucial details of implementing these models. Hospital managements are worried about being left behind in the headlong rush toward adoption of ACOs and other value-based reimbursement models. Against this backdrop, healthcare providers now confront a growing list of urgent questions:

  • Which of the emerging population health-based care models is right for our hospital?
  • How much risk is prudent for our hospital with these new reimbursement models?
  • Should we move to an ACO, or is that too big of a jump for our hospital?
  • How does our management team even start to plan effectively to make the shift to a prevention-focused care and reimbursement model? Where do we begin?
  • What is the optimal time-frame for making these changes?

Using a “Scorecard” to Assess Your Population Health Readiness

So, how do hospital leaders break through the confusion and uncertainty to put their institutions on a clear path toward a successful population health-based future?

An effective way for hospitals to manage this process is by using a “scorecard” based on industry benchmarks to assess their relative readiness for – or current performance in – adopting a value-based reimbursement model.

The scorecard contains metrics that quantify the financial and volume impact on a hospital when it transitions to a population health-based reimbursement model. These metrics can be grouped into a range of key categories – i.e., top 5% high-cost patients, non- urgent emergency department visits, avoidable admissions, readmissions, physician overuse, outpatient procedures performed in lower cost settings, and proportion of one-day inpatient procedures done as outpatient. Hospital managements can address each of these categories in order to reduce per-member, per-month costs of care.

For example, new risk-sharing models have created more impetus for physicians and health systems to work together to prevent avoidable admissions. In 2011 alone, potentially avoidable admissions accounted for 10-14 percent of total inpatient admissions for most hospitals. With the growing push to reduce avoidable admissions, an average 300-bed hospital could potentially lose $9.5 million in annual contribution, as they would no longer obtain volume/revenue from these avoidable hospitalizations. On the flip side, if a hospital doesn’t prevent avoidable hospitalizations, they would be penalized for these unnecessary visits.

The emerging population health landscape has also resulted in hospitals experiencing growing competition from lower cost settings such as Ambulatory Surgery Centers (ASCs). Over the past decade, the number of ASC operating rooms has doubled. Historically, ASCs and hospitals shared in the growth of common procedures such as shoulder arthroscopy. But, with 60 percent of hospitals now within a 5 minutes drive from an ASC, and given the industry’s accelerating shift to population health models, ASC’s price advantage puts hospitals at a competitive disadvantage.

The scorecard gives hospital executives the ability to accurately assess the financial and volume impacts of population health-based reimbursement models to their institution. This is critical in identifying opportunities for improvement, setting priorities, and making key strategic and operational decisions that will help guide a hospital through periods of great change and uncertainty.

Population-Health

Key Principles for Implementing Population Health

Through our work helping hospitals to prepare for a coordinated care future through strategic assessment tools like scorecards, we have identified three key principles that help to drive a successful transition:

1. First, the entire organization needs to embrace change – To engineer a successful shift to one of the new risk sharing business models, your hospital’s management team – indeed the entire organization – will need to embrace change. The fact is, much of that change is already happening right now, so it makes sense to manage it in a way that works best for your hospital’s specific needs and culture. The scorecard process will help your senior management team to clarify goals, assumptions and priorities around where the hospital needs to go, and how best to get there, in the population health future.

2. Plan for “evolutionary” change – Moving to a new value-based health system need not involve a wrenching “revolution” for your hospital. Indeed, jumping headfirst into the unknown is a recipe for disaster for most providers. Taking well planned, incremental steps is usually the best and least disruptive way to evolve to a fundamentally different reimbursement and care model like population health. For example, some hospitals are starting with their own employee populations to experiment with ACO-like care models.

3. Learn to love data – It’s an article of faith in management that you can’t improve it if you can’t measure it. At the core of the population health scorecard assessment approach is the imperative to collect the right data, analyze them, and then continually measure your actions and results as your hospital travels along the population health journey. Data are essential for effective decision making, and also for implementing a new risk sharing reimbursement model at your institution.

Implementing the fundamental changes necessary to meet the historic challenges now confronting healthcare providers has been compared to swapping out the engines in a jet plane – while it is still airborne! As daunting as that metaphor sounds, hospitals can successfully evolve to the population health-based future if they take the right steps to plan for the changes and implement them in a methodical, data-driven fashion.

Careful planning and practical assessment tools like the scorecard help hospital leaders make smarter strategic decisions around value-based healthcare.

About the Author

Dr. Russ Richmond is the CEO of Objective Health, part of the global McKinsey healthcare practice, which serves hundreds of public- and private-sector organizations worldwide. He is passionate about the use of data to manage health and to improve healthcare performance. Dr. Richmond holds an MD from the University of Cincinnati and a BS in Biology from the University of Michigan.

Conclusion

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Enter “Population Health” Management

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Understanding the Costs and Risks

Dr. DEM

[By Dr. David Edward Marcinko MBA]

By http://www.MOL.com

Gratefully, our book, Financial Management Strategies of Hospitals and Healthcare Organizations [Tools, Techniques, Case Studies and Checklists] has become an academic best seller.

It contains a chapter on Wellness and Population Health 2.0; included here for your review [By Jennifer Tomasik, Carey Huntington, and Fabian Poliak].                 .

Population Health

I am especially proud of this work for 2016.  This managerial book mimics the popular style of colleague Atul Gawande MD in his acclaimed work The Checklist Manifesto.

Why? All hospitals are still subject to the imperative: No Margin – No Mission.

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Pop Health

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Assessment

In an example of population health management and policy leadership, another colleague, David B. Nash MD MBA of the Wharton School, and Endowed Dean of Jefferson University Medical School [father of population health], even wrote the “Foreword”.

Click on this link to read it entirely.

Link: Foreword.Nash

More:

Conclusion

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