Population health means comprehensive value-based care!

By Moshe Starkman, nThrive Senior Director, Value-Based Reimbursements | Posted: 02/20/2019

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The definition of “population health” is nebulous because it means different things to different audiences across health care. Recently I presented several definitions of population health at the NH HIMA Winter meeting and highlighted a commonly accepted distinction between population health and public health. Over the course of our discussion we came to understand how value-based care is the synthesis of sick care, preventative care, and wellness promotion through greater patient engagement, stronger patient solutions, sophisticated technology and analytics, and a top-down commitment to excellence across the continuum of care.

Defining population health

According to the National Center of Biotechnology, population health is defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” This is the definition that Wikipedia picked up and is generally accepted as the common definition for population health.

However, the Centers for Disease Control and Prevention (CDC) takes this one step further, noting that population health is “the distribution of health outcomes within a population, the range of personal, social, economic and environmental factors that influence the distribution of health outcomes, and the policies and interventions that affect those factors.”

Explicitly accounting for “personal, social, economic and environmental factors” is key, as true population health goes well beyond treating a defined population and is more about understanding what makes a population tick, especially when exercising interventions for successful preventive care – versus just post-acute care.

This distinction is fundamental to the success of scalable population health. For instance, how you fashion pop health initiatives for rural versus urban environments may be very different given societal norms. Rural communities may be less “plugged in” than urban communities but on the flip side they have stronger real-life social networks. Every community holds inherent advantages and disadvantages which need to be accounted for by your health care organization when defining an effective and successful pop health strategy.

Population health versus public health

Where population health has traditionally focused on improving health care for a population, public health is generally understood to focus on preventing outbreaks of diseases and determining policy to manage potential outbreaks.

For instance, whereas population health focuses managing diabetes for a given population, public health may concentrate on reinforcing handwashing policies in the food industry to prevent the spread of food poisoning.

The definition of Population Health Management, as I define it, is “Value-driven health care with an emphasis on acute episode prevention, improved post-acute transitions, disease prevention and management, and patient-compliance improving social services.”

Defining VALUE-driven health care

nThrive Chief Medical Officer, Carl Couch, MD, MMM, often quotes the well-known business guru, Michael Porter, who defines value in terms of this simple equation:

nThrive value-based health care solutions

The point here is that value is defined by the outcomes that matter to patients when provided at a cost they're willing and able to pay. We’ve all seen the old medical joke where an operation was a success but the patient died. No matter how technically flawless the procedure, if the activity fails to benefit the patient or produce a better outcome it is considered non-value added.

Making population health work

Ultimately, making population health work for patients and providers requires garnering greater insight into communities and utilizing the wealth of health care data that we’ve never had access to before now. Contemporary technology and analytics are introducing both the clinical and financial insights necessary to achieve the Triple-Aim: managing population health, reducing care costs and improving the experience of care.

This is an exciting time to be involved in U.S. health care. Ever stronger health information technology (HIT) and greater access to patient data across the spectrum has enabled our industry to deliver on high quality and affordable health care for anyone in need (or to further prolong the necessity of any given individual to receive acute inpatient, often preventable, costly care.)

 nThrive can help your health care organization unlock the power of data and analytics to boost your level of care and enhance your revenue cycle. To learn more, e-mail us at solutions@nThrive.com or call us at 678-323-2500.