Top population health management challenges hospitals face

Hospitals and health systems that treat some of the country’s most vulnerable populations face complex challenges when working to improve population health.

Though many of these healthcare organizations can define population health needs, they struggle to implement strategies that can help patient populations.

"Population health approaches present an enormous opportunity for essential hospitals and their patients," says Bruce Siegel, MD, MPH, president and CEO of America’s Essential Hospitals. The association represents 275 hospitals and health systems that assist low-income and uninsured patients. "But they can face resource constraints and other challenges to getting a program off the ground."

In January 2016, the association received a $327,000 grant from the Robert Wood Johnson Foundation to study population health, and developed a roadmap for health organizations that work with vulnerable patients to implement strategies for building and sustaining community-integrated care.

The top challenges hospitals face

“Our research showed that hospitals will need the most help with aligning payment to support this work, developing and training workforce with the skills needed to address the social determinants of care, and developing IT analytics systems that are conducive to population health activities,” says Kalpana Ramiah, DrPH, director of research for America’s Essential Hospitals. “We also found that in terms of education or training, hospitals are looking for help articulating return on investment, establishing metrics for measurement, and monitoring or evaluating their programs.”

Ramiah says that research shows that many health organizations are moving in the right direction when it comes to population health, but there is a lot more work to do.

“We were surprised to see that a substantial number of hospitals have designated senior staff positions-vice presidents, directors-specifically to population health,” Ramiah says. “This speaks volumes to how much more focus there is on population health in these traditional care delivery systems, and shows commitment and buy-in from leadership at a high level.”

Ramiah says that research shows 75% of hospitals surveyed had partnerships with social services. However, identifying more meaningful and sustainable community partnerships could help hospitals in meeting population health goals.

“Some of the barriers have been that these different sectors have not always worked together, and they may need to overcome communication challenges and perceptions of competition before they can feel comfortable sharing responsibilities and resources,” Ramiah says. “By talking to our hospitals, we found that when partnerships are successful, they call on a common language, mutual trust, and clearly defined roles.”

Cost is another factor that prevents hospitals from sustaining population health programs, Ramiah says. “There is a pressing need for sustainable funding to really be able to address social determinants in a systematic way, and hospitals will need consistent payment and policy alignment to move forward.”

The roadmap features three key areas to move essential hospitals from strategy to action:

1. Build a foundation for population health;

2. Assemble and align needed resources; and

3. Implement community-integrated healthcare.