Population Health Management –Toward a Life Centric Model with Consumer as Co-Creator of Value

Rose Maljanian Chairman & CEO HealthCAWS,  Chairman of the Board Population Health Alliance

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Population Health Management strategies continue to gain recognition as must haves versus nice to haves in order to survive and thrive in a value based health care environment.  The mainstay component parts of upfront analytics, targeted and individually tailored interventions and outcomes1 continue to evolve as new science and technology becomes available.  Each member of the healthcare ecosystem has an important contribution and is poised to be appropriately compensated based on the value that they contribute.

Forward thinking health systems, ACOs and new entrants to the health care space continue to push the boundaries on moving care and support services out of the traditional hospital  environment where possible into the community where life happens.  Like time spent with an accountant filing taxes or a day in the garage getting a car fixed, as an industry we have come to accept that most always a good day for a consumer does not include a trip to the emergency room, hospital, laboratory, or doctor’s office but rather optimizing time spent doing what they like to do, feeling as good as they possibly can.

Furthermore, consumer engagement and experience has taken center stage as consumers publicly rate providers, facilities and health plans and more easily can take their business elsewhere if their needs are not being met.  In addition, the shift to value based payments has aligned incentives for providers to more proactively and effectively engage their consumer patients in their care, leveraging extender digital tools and care team members to take their reach beyond the visit time and beyond the walls of the healthcare environment.

A finer point on the need to engage consumers was made by Alan Weil in his 2016 Health Affairs editorial entitled the Patient Engagement Imperative when he stated- “There is recognition that the patient is co-producer of the outcomes for which the physician is now being held accountable”.  Translated to all stakeholders – the patient, the member, the consumer, the community resident is co-value creator and not only is the physician held accountable but the hospital, the health plan, the employer, the business associate partners all have performance targets to meet related to their roles in optimizing health, cost efficiency and the consumer experience.

As I said to a recent audience of thought leaders gathered to share innovations in population health-“think about this quote- no matter how great you are; no matter how great your programs are; you cannot produce the desired outcomes without the consumer”. 3

If all stakeholders come together around this Life Centric model and partner with consumers as co-creators of value to them and the system overall, we will see movement from a costly, mediocre quality and full of hassle system to one recognized for being a high value, desirable when needed solution, that enhances versus disrupts life.

  1. Population Health Alliance –PHA PHM Framework. http://populationhealthalliance.org/research/understanding-population-health.html
  2. Weil, A. The Patient Engagement Imperative. Health Affairs April 2016.  DOI: 10.1377/hlthaff.2016.0337.
  3. Maljanian R. Impact of Population Health in a Value-based World. SSN Population Health for Medicare Medicaid and Dual Eligible Populations. Keynote May 15, 2018 https://www.pophealthsummit.com/index.php

 

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