How the Industry Has to Prepare for Population Health Management

In a time of regulatory instability and rising costs, population health management, or PHM, has become increasingly important for the healthcare industry. By defining groups related by geography, demographics, environment, and social factors, care providers can develop strategies for detection, early intervention, and, when necessary, treatment of common chronic maladies. Healthcare can become anticipatory rather than reactive, with efforts paying for themselves in four years.

However, to take advantage of the benefits of population health management, care providers must be ready to implement the strategies and tactics to enable the concept. That takes preparation.

For example, a recent national survey shows that 74 percent of organizations have a group that focuses on population health already. And yet, executives face challenges including a lack of physician engagement, particularly as they don’t understand the potential effect on workloads and pay, and a decline of payer enthusiasm for PHM-based risk-sharing agreements. Any work in PHM must address these issues early on.

According to Tomi Ogundimu, practice manager of research for The Advisory Board Company, another necessary component is diversity in healthcare experience among those in charge, including experience with both providers and payers.

“Regardless of title, these leaders frequently share certain characteristics, including relatively long tenure at the organization, and they could have clinical credentials, but not a physician—most often a nurse leader,” Ogundimu says, adding that leaders with diverse background bring two important skills to population health management.

Some of the areas of strength that PHM needs are change management experience, advanced financial expertise, and data analytics. A report from Spencer Stuart and the American Hospital Association suggests to also look outside traditional healthcare backgrounds for a “broader set of leadership and technical skills.” Another way to put it is that no one person can effectively oversee a move to PHM, meaning a team approach is necessary.

Full preparation isn’t only up to the providers. The American Medical Association has noted how medical schools largely fail to present information on important topics like PHM to students. The doctors of tomorrow aren’t learning about the new approaches to clinical practice being implemented today at providers. Until the lag begins to change, graduates will need remedial training to gain the knowledge and skills they need to work within modern systems.

Care organizations must work internally, reach outside, and communicate their needs to medical schools to create an environment that can effectively support and develop PHM practices.

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