How to prepare for population health

Most healthcare executives agree that population health management is an important part of the success of their organization. However, many executives run into barriers when it comes to getting buy-in from key stakeholders that can make population health strategies successful.

Nearly 95% of survey respondents see population health as an opportunity to improve control of clinical costs, quality and outcomes, according to a survey conducted by Numerof & Associates of more than 500 c-suite healthcare executives. Survey results were presented at the National Association of Managed Care Physicians (NAMCP) Spring Managed Care Forum 2017. The survey also found that 74% of healthcare organizations have designated a division, department or institute that focuses on population health.

Although there’s been a growth in interest and infrastructure to begin tackling healthcare from a population health standpoint, executives are still trying to clear culture hurdles to implement strategies.

White

“Population health management will occupy a significant place in the future of healthcare, but the journey, for many, is formidable. Implementing and achieving success in population health management involves a completely new mindset.  Unlike the current model, providers must focus on the entire care continuum-from preventative care programs to post-acute facilities,” according to the authors of the study.

Kimberly White, MBA, vice president at Numerof & Associates, says that physician buy in and an increase in payer collaboration are two of the challenges facing system-wide population health adoption. The survey found that 43% of respondents view their organization’s ability to manage variation in quality at the physician level as average or worse.

“One of the challenges organizations face in driving change is physician engagement. Often physicians look at organizational initiativesas the ‘strategy of the month,’ and they don’t feel it will last,” says White, who presented the survey results at the NAMCP Spring Managed Care Forum in Orlando, Florida.

White says that physicians don’t get a clear understanding of expectations and how special projects may affect their workload or pay.

White says that physicians don’t always feel they have a clear understanding of expectations and how special initiatives may affect their workload or pay.

“Executives need to present a very clear vision and create an ongoing communication strategy with physicians so that they understand where this effortis going, why it’s happening, and what’s in it for them,” White says.

The survey also found that payer enthusiasm for entering into risk-sharing agreements has declined. Only 17% of respondents report that their organizations are very prepared to take on risk. White says that payers are skeptical about how ready providers are to take on risk-sharing agreements.

“When we talked to payers, they say, ‘We are ready but we don’t know if providers are able.’ Payers are worried that providers aren’t able to manage variation in cost and quality and drive necessary change,” White says. 

More than 75% of survey respondents say that their organization has at least one risk-sharing agreement with a payer. But risk-based contracts are still a small part of many providers’ financial portfolio. The majority of respondents said less than 10% of revenue comes from risk-based contracts with payers.

White adds that both payers and providers need to address joint problems and the misalignment of goals and objectives to get past the stagnant issues that halt collaboration.

“Both sides have this idea that, ‘They don’t want to work with us,’” she says. “Most organizations are just experimenting with risk-based agreements, but we expect the healthcare industry to move in this direction. But it’s not a flip-the-switch activity. It’s about creating and adapting processes, and cultural change. If organizations can start doing that now, many more will be prepared for the future.”