“There is nothing more important [in healthcare] than the transition from traditional medicine to population health and the implications that will have.”
So said David Nash, MD, founding dean of the Jefferson School of Population Health in Philadelphia during a session at Becker’s Hospital Review 5th Annual Meeting, May 15 in Chicago. Dr. Nash described the benefits of focusing on population health, and why hospitals and health systems do not yet have a viable population health strategy in place.
Professional medical care is just a small fraction of what affects a patient’s health, said Dr. Nash. Healthy behaviors, environmental factors and genetics are much larger determinants of overall health and patient outcomes. However, 88 percent of the country’s health and wellness spending goes toward professional medical care. “It’s wasteful, expensive and not sustainable,” he said, and not the best way to improve the health of patients nationwide.
Population health has been getting more attention recently, mostly due to provisions in the Patient Protection and Affordable Care Act. “The [PP]ACA is the first baby step to turn this battleship around in the Panama Canal,” said Dr. Nash. Large employers, from whose pockets come $0.52 of every dollar spent on healthcare in this country, are also making a push to have providers focus on maintaining health, rather than treating expensive, preventable conditions.
However, several barriers stand in the way of providers adopting a population health strategy. The first is technological limitations. Current health IT does not have the functionality needed to properly manage population health, said Dr. Nash. “Electronic medical records are nifty, but we need a registry function… that will help us figure out how we’re doing with a population,” he said.
Also, healthcare providers aren’t feeling the “pain” of not managing population health. The U.S. healthcare system is still largely fee-for-service, meaning hospitals and health systems can still successfully operate under traditional models. But not for long, says Dr. Nash. “There’s just not enough pain yet,” he said. “You haven’t seen a big medical school close yet [because of lack of focus on population health] but you will, you haven’t seen any doctors out of business yet because they didn’t take this risk, but you will.” He summed it up with a simple phrase he believes will hold true in the future: “No outcome, no income.”
To start moving toward population health management, Dr. Nash recommends focusing on both transparency and accountability. Take care of employees, engage consumers and reach out to pharmacists, retail clinics and other providers to find the best health management strategies.
“It’s a gut-busting, difficult job,” said Dr. Nash. “But it’s the biggest part of what I see in the future.”
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