Home' The Source : Fourth Quarter 2013 Contents When it comes to population health
management, there are few more in tune
with the promise and challenges it presents
than David Nash, M.D., MBA , founding
dean of the Jefferson School of Population
Health at Thomas Jefferson University in
Philadelphia. Nash began his career as a
board-certified internist, and then became
involved in promoting quality improve-
ment and advocating for policy change in
healthcare. He founded the school in 2008
as the first U.S. academic institution focused on population health.
Nash was a featured keynote speaker at the annual HealthTrust
University Conference & Vendor Fair in August. He spoke recently
to The Source about healthcare reform from the angle of population
health—and shared his strategies for moving from volume to value,
especially in the supply chain arena.
Q: How did the healthcare industry get to the point where
it needs to, in your words, “turn around the battleship in the
A. We first got into this jam by thinking more is better—we called
for more catheters, more procedures, more parking spaces, more
buildings. But that’s a failing strategy. We need to consider the value
equation—what we’re getting for what we’re spending. The goal is
to move from volume to value.
Imagine a medical administrator in a canoe poised between a
fork in a rushing stream. One route represents “more is better” and
fee-for-service. This is the route of no antibiotic stewardship, every
Challenges like epidemic rates of
chronic disease, evolving healthcare
reform and the need to expand capacity
to accommodate growing numbers of
Medicare enrollees all make it clear that
“business as usual” just won’t cut it. And
as reimbursement systems move away
from a fee-for-service structure under
new healthcare legislation, organizations
will be held accountable for both
efficiency and quality of delivered care.
In response to these challenges,
healthcare systems and physician groups
are developing new programs aimed at
improving population health as a whole.
Population health management (PHM)
is a systematic approach to addressing
the preventive, high-risk and chronic
care needs of patients, with a goal of
minimizing costly interventions like
emergency room visits, hospitalizations
Continued on page 28
Central to this new healthcare management model is regular
interaction with patients across all risk levels, focusing as much on
wellness as acute care. To that end, PHM employs a combination of
individual, organizational and community interventions to improve
patient outcomes and adapt to change in the healthcare system.
Interconnected Roles, Shared Benefits
Patient data analysis, robust relationships with primary care
providers (PCPs) and the integration of services with public re-
sources serve as the backbone of the PHM model.
Information gathered during annual health assessments and
primary care visits provide PCPs with the data necessary to design
care plans personalized to patients’ risk profiles and proactively
engage patients in behavior modifications before larger health is-
sues arise. Not only does this save time and money for the provider,
but program participation often gives patients expanded benefits
and cost savings as well.
The move toward improved portability of electronic patient
data also means healthcare organizations can more effectively plan
and target care to specific population health needs. For instance,
utilization data can help organizations build facilities with mul-
tiple services under one roof, improving efficiency while creating
a better patient experience.
In addition to proactive doctor-patient relationships and data-
driven decision-making, community resources play a critical role in
the population health model. A shortage of physicians means PCPs
Making Population Health
will continue to lead care teams of not just advanced practitioners
and nurses, but also expanded social service providers such as public
health agencies and community groups. These resources can prove
instrumental in helping patients overcome non-clinical barriers to
improved health while complementing available healthcare services.
For example, community health workers or resource specialists
can help coordinate transportation options for patients, arrange
for translation services or even provide mentoring programs to
help people better manage chronic illnesses such as diabetes.
Collaborating with community resources allows healthcare or-
ganizations to make a bigger impact on population health and
ultimately serve more individuals.
Of course, developing the necessary infrastructure and technology
to support PHM’s goals and objectives is no small task. However,
the challenges of modern healthcare demand a new approach and
population health is a promising model for meeting those chal-
lenges head-on. In fact, PHM programs can reduce costs, improve
the quality and efficiency of care and expand system capacity to
meet future needs—all of which are vitally important to improving
public health over the long term.
26 The Source | Fourth Quarter 2013
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