What is Population Health Management?

Population Health

“The health outcomes of a group of individuals, including the distribution of such outcomes within the group.” David Kindig, Institute for Healthcare Improvement

Population health has infiltrated the healthcare industry, and it’s here to stay. Population health seems to be the answer for a lot of my graduate school test questions, it’s included in all of my project solutions, and honestly, the first time I heard about it I wrote it off, because it seemed too simple to actually work. In fact, population health is so simple that healthcare professionals across the country glaze right over it, too. This is why we at Clarify stress the importance of great population health management strategy with all of our clients.

 

Let’s restate the obvious - the U.S. healthcare system is in the midst of a major transition, and for the first time in a long time, managing the health of a given population is taking priority over individualized healthcare.  In graduate school, my professors teach me and help me develop skills to navigate our evolving healthcare system. But most importantly, they are teaching me how to think. Population health has a definition, but it is more importantly a mindset about how we provide healthcare. When we change our mindset to focus on groups of patients in order to put processes and reliable systems in place, everyone wins.  

 

Population health can encompass an endless number of different types of groups. They can be as broad or as specific as needed. Who makes up the group(s) will vary based on patient populations, health conditions, socioeconomic status, geographic location, and so on.

Here are a few examples:

  • Population of a town

  • Employees at a company

  • Prisoners

  • Diabetics in a given state

  • Patients at a primary care practice with any given condition

Once the population is defined, the next step is figuring out how to effectively manage it. That’s where population health management (PHM) comes into play.

 

Population Health Management is Effective and Impactful

Population Health Management is, “The compilation of patient (or group) data, the analysis of that data into a single, actionable patient record, and the actions through which providers can improve both clinical and financial outcomes of the group. PHM involves the design, delivery, coordination, and payment of high-quality health care services to manage the populations we identify while using the best resources available.” -IHI

PHM encourages:

  • New partnerships between providers & payers

  • Effective utilization of technology

  • Care management models

  • Implementation of non-traditional healthcare professionals

  • Risk to be successfully transferred from payers to healthcare organizations

  • Implementation of and reliance upon processes and systems to make appropriate and necessary patient care more predictable                                                                                                        

“We frequently hear from health care professionals and sometimes even clients that they’re skeptical. It’s always enjoyable to hear positive feedback and stories from these same people when they see the difference PHM makes for their organization, providers, care teams, contracts, and patients. It’s a really powerful moment when the light bulb comes on.” -Amber Winkler, Clarify CEO
 

PHM principles and activities can be applied at every level of the healthcare industry and in many different ways. The possibilities are endless. Current trends include:

  • Accountable Care Organizations (ACOs)

  • Patient-Centered Medical Homes (PCMH)

  • Risk stratification methods

  • Patient registries

  • Insurance companies

  • Large companies who are self-insured

 

We love working on population health with our clients. We research how PHM can benefit different healthcare organizations. We know PHM helps improve patient outcomes. We watch PHM improve the quality of care our clients provide. We see our clients drive business and gain critical reimbursement dollars. And finally, we are strong believers that a population health mindset has the power to make your organization strong enough to excel and stand out from your competition in this ever changing healthcare climate.

Sources: IHI


Written by: Anderson Wiksell