Population Health is Alive! (Despite Policy Uncertainty)

Healthcare law in the U.S. is anything but settled. The first effort to repeal and replace the Affordable Care Act (ACA) failed, but what’s coming next?

Amid instability, the big-picture ambitions of healthcare professionals haven’t changed. If there’s any doubt that improved population health remains an unwavering goal for U.S. healthcare professionals, look no further than the conference circuit. The HIMSS Population Health Forum, held in Boston last week, drew hundreds of attendees. Throughout the event, the message was clear: Population health (and value-based care) aren’t going away, no matter what happens at the federal level.

Population Health: The health and well-being of the greater human population

Why? Well, for one, healthcare professionals want to make a difference in societal health. That’s why they got into the profession in the first place. But there’s no denying that cost plays a major part in population health, too. According to the Centers for Disease Control and Prevention, chronic disease (diabetes, asthma, and COPD, and the like) accounts for approximately 75 percent of the nation’s aggregate healthcare spending—or an estimated $5,300 per person in the U.S. each year. An oft-quoted statistic is the 80/20 rule: 20 percent of patients account for 80 percent of spending.

Obviously, preventing patients from getting sicker (and requiring more advanced—read:  expensive—care) will help reduce costs. But another way to improve the bottom line is to focus on creating more satisfied patients–coincidentally, often a positive side effect of population health initiatives. Deloitte recently reported that hospitals with “excellent” HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) patient satisfaction ratings over a six-year period had a net profitability margin of 4.7 percent, on average, compared to 1.8 percent for hospitals with “low” ratings.

Value-Based Care: A focus on the long-term effectiveness of treatment over the volume of patient encounters

And then there are regulatory pressures. The Medicare Access and CHIP Reauthorization Act (MACRA), a federal law that increasingly compensates providers based on treatment effectiveness, will be rolled out in stages over the next few years, with the aim of tying 50 percent of Medicare fees to performance by 2018.

Private players have an even more ambitious goal. An alliance of health systems, payers, purchasers, and patient stakeholders have declared their intention to link 75 percent of reimbursement to performance by 2020.

This all sounds great in theory, but how can providers and facilities actually make it happen?

Enter the Digital Healthcare Revolution

Undeniably, the move to value-based care requires a shift in mindset and major changes in processes and workflows. But very little change would be possible without the technological innovations being implemented today.

Just a few examples: Outreach campaigns driven by advanced data analytics are helping to automate proactive patient engagement. Remote monitoring, connected devices, and telemedicine are keeping doctors and patients connected. And apps and portals are finally starting to catch up with consumer digital behavior (think Amazon).

One facility that’s ahead of the curve is the Mercy Virtual Care Center in Chesterfield, Missouri. Mercy’s facility is unique in that there are no patients in the building–just healthcare professionals and technology. Through the power of the digital network (and in partnership with Cisco and World Wide Technology), they’re making sure people with chronic conditions get the care they need.

Dr. Randy Moore, President of Mercy Virtual, sees a direct connection between advanced technology and quality patient care. “I want to see a person on Wednesday, when they have a minor issue, instead of Friday, when they have a major issue,” he said. And that, in a nutshell, is exactly the goal of population health.

At the recent HIMSS Population Health Forum, Nathan Tierney of the Department of Veterans Affairs argued that the key to improving healthcare is creating the health outcomes that matter most to the population. “Value for patients should be the overarching theme,” he said.

Improved health and better value? Why, there’s never been a better time.