Last month, COPE Health Solutions and Montefiore Health System brought together health care leaders from across the country to New Orleans to devote two days to discussing population health. This invitation-only event provided an opportunity for an intimate discussion of hot topics, shared experiences, strategy sessions and networking with other industry professionals.
Throughout Population Health 360, key themes emerged as opportunities for discussion and further thought as our leaders continue down the path to successfully moving from volume to value. The following is a high-level summary of a few of these themes, among others:
- Culture Change is Critical to Success
Significant strategic decisions that inform a health system’s strategy do not always fully incorporate on-the-ground clinicians that will be responsible for executing the vision. Attendees discussed the critical need to include providers from the very beginning in developing strategy in order to gain clinical buy-in and educate providers prior to implementing new strategies. Health systems shared how they were able to succeed with health benefit programs for employees who mirror their patients, as well as with provider education programs that offer providers an opportunity to learn about their population needs and the rationale behind a shift to value-based care.
- Care Must be Coordinated and Consistent Across the Full Care Continuum
Care coordination is a critical aspect of any managed care strategy. Attendees shared examples of misaligned coordination efforts when multiple stakeholders are involved and how they addressed these issues. For instance, a care coordinator from the hospital, the health plan and the IPA or ACO may contact a patient after an emergency department visit. While these efforts intend to improve patient care, this can lead to duplication of work, misaligned care planning and crossed communication with the patient. Our panel members discussed strategies to centralize and obtain delegation for care coordination across their networks in order to ensure consistent messaging and the most coordinated experience for their patients.
- Integration of Behavioral Health is Essential
As providers move into risk-based arrangements and begin to take on full accountability for cost-effective care delivery, integration of behavioral health becomes increasingly important for managing population health. Our esteemed panelists acknowledged that this is crucial challenge that must be addressed. Success in payor contracts with downside risk for the health system or provider relies on reducing avoidable high-cost services such as emergency department visits and inpatient admissions or observation stays. Integrating behavioral health services into a whole-person care approach ensures that patients are able to seek services for mental health and substance use disorders in the most appropriate setting and prevent costly visits and admissions, thereby increasing the dollars available for savings. Understanding the needs of a specific population is critical to ensuring the network of providers is adequate to provide these services, and the care coordination resources are in place to ensure services are appropriately utilized to mitigate costly, episodic care.
- Aligning Physician Incentives
Providers are commonly subject to a lengthy list of performance measures written into numerous contracts. They may be responsible for various sets of measures imposed by multiple managed care organizations, and even more through their employer health system, IPA, ACO or government programs such as DSRIP. Improving population health requires a focused set of performance measures that tie directly to the needs of the population and managed care contracts. This allows providers to focus on making significant clinical advances in areas that will improve the health and reduce costs for their primary populations, rather than spreading their efforts thin across many measures. Attendees and panelists discussed performance measures that have been effective in their organizations and strategies for aligning physician incentives for their provider networks.
- Data is Fundamental for Managing a Population
Managed care contracting and population health rely heavily on the ability to understand and know your population through reliable data and performance reporting. Our panelists shared insight on how to prioritize the problems you’re trying to solve through data in order to most efficiently recognize solutions and implement performance improvement. This strategy ensures that key stakeholders and providers avoid data paralysis, and instead produce reports built on a framework that matches their needs, while the right data is shared with the right team members. Equally important is developing a strategy for making data reports actionable; attendees shared best practices for implementing strategies associated with problem areas to drive down medical spend and improve the quality of care delivered.
- Population Health is Moving Forward, Regardless of Policy Shifts
A common question asked of our health care leaders throughout Population Health 360 was if population health is a strategy that will withstand ambiguous policy in Washington D.C. Consistently, panelists and attendees responded positively and overwhelmingly agreed that population health is not only here to stay, but critical to maintaining financial sustainability over time. The federal and state governments cannot afford to reverse the cost containment achieved through Medicare Advantage and managed Medicaid.
These are just a few of the many themes, shared experiences, and lessons learned that emerged from the conference. Attendees gained not only strategic and practical insights, but renewed vision and new potential partners in the transition to population health. A few of our attendees were kind enough to share testimonials of their experiences.
“This was the best conference out of all the ones I have attended throughout my 20 plus healthcare years as an executive. It was well organized with key leaders on the panel and in attendance.”
– Adam Darvish, Senior Vice President, Kindred Healthcare
“This conference on population health management is extremely good. We’ve seen not only practical experiences but we’ve also seen some conceptual issues thrown out for discussion and future considerations.”
-Duane Dauner, President and Chief Executive Officer, California Hospital Association
“We’re able to interact with each other much more effectively than the ‘normal’ conferences.”
-Ram Raju, M.D., Senior Vice President, Community Health Investment Officer, Northwell Health
As the health care industry embarks on the journey towards value-based payment, population health will be a central strategy employed by successful organizations to understand their populations and manage their care. Population health, and in particular the key themes mentioned above and discussed at Population Health 360, are the foundation for enhancing your organization’s ability to reduce utilization, lower medical spend and improve patient health outcomes. Effectively achieving these goals will empower providers to excel in risk-based contracts and succeed in a managed care environment.
COPE Health Solutions and Montefiore Health System will be hosting a regional Population Health 360 conference in the spring of 2018 and our second annual Population Health 360 in the fall of 2018. Stay tuned for more information or if you’d like to be added to our invite list, please contact us at email@example.com.