Population Health Management; This is a buzz phrase that we hear all the time. This verbiage is thrown around at a steadily-increasing rate by those who understand it, by those who want you to think that they understand it, as well as by those that obviously don’t understand it at all.
Wikipedia (Because what more reputable resource exists than Wikipedia!?!?) defines Population Health as The health outcomes of a group of individuals, including the distribution of such outcomes within the group. I guess that makes sense… But what does that really mean? And how does Pharmacy Practice actually fit into that?
I suppose I could list what I feel my organization is doing in the realm of population health management, and maybe I will at some point. At this point, though, I’m more interested in the things that I haven’t yet heard, or even considered. I suspect that some of you out there are currently engaged in some really cutting-edge practices and initiatives. I hope those of you that are will share what you’re doing on this blog.
Before we get to that, though, I’m going to list what I feel are some important things to consider when attempting to actually engage in population health management. Beware… this list is not derived from primary literature sources or peer-reviewed journals… It’s just my unorganized stream of consciousness…
Population Health Management is:
- The act of caring for individuals that routinely access the healthcare system, but also the implementation of outreach initiatives to attempt to engage those that don’t (i.e. the entire population).
- The development and implementation of disease-state management services. This involves incorporating disease-state specific best-practice standards in the provision of care to a population that suffers from a common condition.
- Combining treatment for existing conditions with programs that emphasize the prevention of others. In addition, Wellness initiatives are emphasized and incorporated into the care of all.
- Caring for specific population subsets within the overall population. These subsets may be bound together by like conditions, demographics, or socio-economic factors, to name just a few.
- An understanding of the role of social determinants of health. These include, but are not limited to, housing, education, income, and the community/ neighborhood that the individual is a part of. Did you know that you can determine your life expectancy based upon your zip code?!?! https://www.rwjf.org/en/library/interactives/whereyouliveaffectshowlongyoulive.html
- A focus on the Value Equation of Healthcare, where Value (V) = Quality (Q)/ Cost ($)
Population Health Management may:
- Involve value- or risk-based payment models like Accountable Care Organizations (ACO’s), where payors and healthcare networks work together to improve outcomes and reduce overall expenditures for a specific population.
- Involve quality metrics that are tied to institutional reimbursement, so that those organizations that provide the best care, also receive the most revenue for like services.
- Involve the use of dashboards or registries so that the individuals who are the most sick, or who utilize the most healthcare resources, also receive the most attention.
- Utilize care coordinators that may be embedded in the ambulatory, the inpatient setting, or both.
- Focus on transitions of care.
What did I forget? Am I missing anything critical? More importantly, what are you and/or your organization doing in the realm of Population Health Management?