True population health requires improving the care for individual patients.
During a Becker's Hospital Review 9th Annual CEO & CFO Roundtable session sponsored by Health Catalyst, Will Caldwell, MD, senior vice president at Health Catalyst, encouraged health systems to embrace population health initiatives that will make a positive impact on the health and well-being of individuals and communities.
Five insights:
1. Population health is about taking care of individual patients. The term "population health" means different things. The term originally focused on the health outcomes of a group of individuals, with no mention of cost. Over time, the concept has grown to incorporate cost. Dr. Caldwell offered a working definition: "The identification and management of the drivers of clinical and financial risk impacting a patient's health, agnostic to payer model." Dr. Caldwell said, "It's a care delivery model, not a payment model." He emphasized, "Population health is a system of care, not a way to get paid," and stressed, "It's the risk owner that's most interested in population health.
2. There is a fierce urgency for population health right now. Three reasons for "why now" are: 1) it's a moral obligation; 2) there is tremendous opportunity and 3) there is significant market-driven innovation. Much of this innovation is fueled by the flow of capital, especially private equity funding. "In 2005, [the focus of private equity] was all things outpatient . . . Now, it's all about telemedicine, behavioral health management, pharmacy economics and virtual care," Dr. Caldwell said. "Pay attention to where those funds are going."
3. Population health requires a smart data approach. "Most of the data that drives a health outcome is not contained within the EMR," Dr. Caldwell said. "Until we get a better handle on that data and can aggregate it and analyze it, we're always going to be hamstrung." Dr. Caldwell suggested a framework of starting with the clinical or data need and then identifying the data sources to address this need, rather than starting with the data.
4. Population health needs to change the care management paradigm. Dr. Caldwell said care management is typically done along five disease management verticals, which cover about half of a given population. He stressed that care management must instead be horizontally integrated, encompassing areas like behavioral health, weight management and preventative and palliative care. "We've got to shift to a more horizontally integrated care management approach if we're going to take care of populations effectively," he said.
5. A broader focus on behavioral health is an unrealized opportunity to improve population health. "It's time to bring behavioral health into the fold," he said. "I would also encourage us to redefine behavioral health as any driver that impact the patient's choices that ultimately leads to better or worse health outcomes."
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