Jeb Dunkelberger, executive director of corporate partnerships for business performance services at McKesson, highlighted 10 centerpieces of a strong population health strategy at the Becker's Hospital Review 6th Annual Meeting in Chicago.
Mr. Dunkelberger said there are four foundational pillars to population health — planning and strategy, network development, practice transformation and care management. In his work with clients and visiting various hospitals and health systems across the country, he's observed 10 traits of leaders and organizations that mark a strong population health strategy.
1. Leaders support a culture of innovation and change. Executives and physicians must challenge themselves to think differently. Mr. Dunkelberger cited the quote often attributed to Henry Ford: "If I had asked my customers what they wanted they would have said a faster horse."
2. The strategy is patient-friendly. Leaders should develop a population health strategy that will appeal to their patient demographic. Include patients in population health discussions by soliciting feedback. "If I ask patients what they want from population health, they don't have a clue," said Mr. Dunkelberger. It's up to hospitals and health systems to engage and educate them as they build up the strategy.
3. Consumerism is embraced. "Now you will have active buyers and patients. Whether or not you agree with the information they find on WebMD, they will bring that with them when dealing with their provider," said Mr. Dunkelberger. It's paramount to equip patients with meaningful information so they understand where the organization stands in terms of quality and how it relates to other organizations in the region.
4. The organization doesn't fight the payer — it becomes the payer. This doesn't mean hospitals or health systems much launch their own health plans, but they should think like them. "How would you manage risk?" asked Mr. Dunkelberger. "How would you manage a population?" These questions demand a different organizational understanding from leaders.
5. Leaders have a global understanding. Speaking of understanding, leaders must expand what they know to several levels. They must know a great deal about other providers in the region and have granular knowledge of their patient demographic as well. "If you are going to get involved with these demographics, you have to understand who you are dealing with," said Mr. Dunkelberger. He stressed the importance of social determinants in population health, and how leaders must really understand the zip codes are more powerful than genetic codes.
6. They put their money where their mouths are. "If you develop the ability to manage risk, allow yourself to be rewarded for your skills and services." Mr. Dunkelberger said the Next Generation ACO is the next the introduction of risk for ACOs. "As CMS does something, commercial payers follow suit," he said.
7. They distinguish correlation from causation. Mr. Dunkelberger said one of his biggest pet peeves is when people see correlation as a causal relationship and build a strategy on that assumption. "Just because indicators point in the same direction doesn't mean they should be called a pathway," he said. "We need to find the cause and the correlation and delineate the two."
8. When developing a population health tool, the hospital acts as the tide and not the wave. "You want to be something that is felt throughout the community," he said. The population health strategy should be felt to people outside of your hospital and people who are not necessarily sick, like the healthy 30-year-old receiving a phone call for his or her annual primary care visit, he said.
9. They make the most of care extenders. Mr. Dunkelberger advised against using the highest cost healthcare providers throughout the care continuum. Duke University Health System in Durham, N.C., began staffing the ICU with nurse practitioners. "It was a cost-effective remedy that actually worked," he said.
10. They are thinking ahead for 2017 and Section 1332. Buried in Section 1332 of the Patient Protection and Affordable Care Act is the State Innovation Waivers program. It's a piece of the law that basically says in 2017, states can request that the federal government waive basically every major coverage component of the PPACA, including exchanges, benefit packages and the individual and employer mandates. "As you look at population health management, if your state decides to do its own thing, it is going to be a very fast-moving change you'll have to be ready for."