Population Health Management Requires Process, Payment Changes

With the healthcare industry changing in a thousand different ways all at once, it’s often difficult for organizations to find an entry point into long-term strategic initiatives like population health management and accountable care.

Providers have often been faced with a chicken-and-egg problem: do they purchase health IT systems that will revolutionize workflow, or decide what changes need to be made and implement technologies accordingly? 

Those controls often center on a robust primary care ecosystem, and may include practice transformation frameworks like the patient-centered medical home (PCMH).  

“If every patient and every consumer is getting comprehensive, coordinated care, they’re going to run into fewer problems,” Vincent stated. “The patient-centered medical home is an excellent foundation for population health management. It is the basis for how you’re able to achieve success with your ACOs.”

However, the patient-centered medical home is not an easy path to follow, and many organizations believe it is prohibitively expensive.  Existing research tends to come out in favor of the PCMH’s impact on quality and cost savings, but few comprehensive studies exist to accurately measure how much providers spent to get there. 

“Estimated figures vary so widely, there’s almost no point in quoting them,” Vincent said.  “I’ve seen studies that pin the costs at $40,000 or $100,000 per physician, but I don’t think there have been enough studies or enough research to really understand the expenses.”

“The investments are hard to quantify.  It’s about the time and the education; the surveys and the tools.  It’s about achieving NCQA certification, and implementing the technology that’s required to support PCMH activities.  Patient portals, tapping into an HIE, and beginning to use technology to coordinate care…it’s hard to say what the true costs are.”

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