Last week, I had the privilege to moderate a webinar that took a close look at enabling a population health management (PHM) strategy. Advocate Health Care, based in Chicago, gave an excellent overview of what they have done to enable a PHM strategy across their network covering nearly one million patient lives. Advocate is clearly one of the shining stars in the PHM realm. They have done a tremendous amount of good work with their IT partner Cerner, openly acknowledge that there is far more work to be done and are willing to share their experiences with others. Hats off to them.
In our discussions with many healthcare organizations (HCOs), we find time and time again a befuddled approach to PHM. At this point in time, I’m not sure whether to pity these organizations or just be downright angry with them. I do understand that most are just struggling to keep the lights on, keep ahead of the barrage of reporting requirements and slowly digest (or is it indigestion) that big EHR go-live and ensuring all clinicians are using the EHR properly.
But the writing has been on the wall for several years now that indeed payment models will shift to those based on value and that HCOs need to get ready to assume the risk associated with these new reimbursement models. Yes, one could argue that fee for service still makes up the majority of reimbursement today but that is a poor excuse for not beginning one’s journey to enable a PHM strategy. One need only look at MACRA, with reporting year beginning in 2017, to see the seriousness of CMS’s intent. And its not like they didn’t warn you.
Getting back to the webinar, Advocate provided some key lessons learned in their PHM journey:
The path is long and circuitous and begins with establishing a clinically integrated network (CIN). Establishing that CIN is seven parts policy, governance and change management and three parts technology. Do not underestimate the challenges in driving alignment (clinical, financial and performance) across your network of salaried and affiliate physician network.
Good data will be key to success, but don’t over-reach. Everyone talks analytics, Big Data, and the like but often HCOs get tied up trying to do too much when they get started on their data-driven journey. Best to start slowly, with a limited set of data whose quality is known to answer some specific key questions. As data analytics aptitude grows, then move on to answering more complex questions.
Never under-estimate executive support. Launching a PHM initiative is far-reaching and will touch ALL parts of the organization. Feathers will be ruffled as changes are made and new processes are put in place. Change management is never easy, requires clear goals and leadership. You won’t get far without executive support.
Start your PHM journey internally. Unlike your EHR roll-out, PHM need not be a big bang go-live – though you will need to move quickly due to CMS and commercial payer pressures. Begin your PHM journey with your own employees. Test care processes, data-sets/analysis, predictive risk/readmissions, care coordination, etc. with your employees to work out the kinks before you roll-out more broadly.
And I’ll add one of my own…
Take a portfolio approach to software that you will deploy to enable a PHM strategy. While a number of vendors have greatly increased their PHM capabilities in the last couple of years, including the sponsor of this webinar, Cerner, we still find that no one vendor can fully enabled a complete PHM strategy.
While I am not at liberty to distribute all the slides that were presented during this webinar, below are the slides that I used that I trust may assist your own internal deliberations as you chart your PHM journey.
And here is the webinar recording in it’s complete form: