The State of Population Health Management

A double whammy of jaw-dropping costs and numerous indicators of an increasingly unhealthy population make the need for clinical reform and population health management clear.


A double whammy of jaw-dropping costs and numerous indicators of an increasingly unhealthy population make the need for clinical reform and population health management clear.

But there are significant clinical, technological, political and financial hurdles to clear before the American health care system can truly address population health management-defined as an effort to step beyond the individual-level focus of mainstream medicine by addressing a broad range of factors that impact health on a population level.

And yet ... some stars are aligning. The HITECH Act in the 2009 economic stimulus law established financial incentives for adoption of EHRs, and a distinct part of that push has been the requirements for the components necessary to track care across the continuum, including clinical decision support; improved data collection, analysis and reporting; and the ability to share patient data within a delivery system and with disparate providers.

The Affordable Care Act followed in 2010 with a range of programs to provide health insurance to more individuals and document they are receiving appropriate, effective, efficient and coordinated care. These programs, still in their infancy as is the EHR meaningful use program, include accountable care organizations and new payment and care delivery mechanisms that introduce bundled payments for services and assumption of financial risk by providers to incentivize collaborative care.

For your consideration: Population health management will accelerate

The incentives embedded in the EHR incentive program and other new care and payment models were necessary to prod providers to focus on the care across the continuum, says Carol Cassell, client service executive for accountable care and analytics at consultancy CTG Health Solutions. As it was, business-as-usual in the fee-for-service environment wasn't going to get the medical community any closer to looking at populations instead of individuals, she says.

Health Data Management’s July cover story on population health management examines the federal thrust to understand and manage the health of large populations is a politically and technologically complex undertaking.

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