Population health is an eye-catching phrase with a vast opportunity for the home health care industry, as providers from all settings are encouraged to work together improve outcomes for their patients. Forward-thinking home health providers are engaged in population health, and identifying emerging trends can help providers stay ahead of the curve.
However, population health doesn’t have one definition; it can be defined based on the experience of the provider and aims to improve the average patient outcome of a patient population through care coordination. What can be easily defined is the role of technology in population health and many of the trends are related to data and the ability of a provider to capture and analyze it.
Currently, the method for technology integration is very segmented, and mostly pushed forward by new regulations demanding quality measures to get a read on how well providers are achieving goals, according to Jeffrey Springer, vice president of Healthcare Solutions at health tech consulting firm CitiusTech.
“Under current regulations, technology objectives become about shiny tools, and you end up with [so many] systems that become hard to mange,” Springer said during the HIMSS Pop Health Forum 2016 in Chicago this week. “Chasing shiny objects is very common. But how do we come up with a strategy for two to five years from now? Now one knows what it will look like.”
While the future of population health is unknown as health care regulations and policies continue to come into fruition at warp speed, there are a few emerging trends in this space that health care providers should notice, Springer said.
Alternative Payment Systems
As the payment system shifts away from fee for service to a value based purchasing system, population health will likely see a boost, according to Springer. Incentivizing the coordination of care between providers is crucial to population health success.
Behavior will only change as the payment system leads the way, Springer said.
“As we move toward payment reform, ROI has to come,” Springer said. “If you follow the money, you’ll figure out the behavior patterns. There was no population health because the payment model was fee for service. Different payments drive different behavior, different types of thinking.”
For example, bundled payment initiatives drive health care providers to coordinate care and become as efficient as possible.
“It’s about being proactive and breaking down the four walls of the institutions,” Springer said.
This shift offers a great opportunity for home health to help drive those efficiencies and better health outcomes for patients once they leave the acute care setting. They way home health can become more involved it through data, which is also emerging in a new light amid the changing payment landscape.
Bottom line, top executives will have to get involved, and value must be proven in a quantitative way.
“CFOs will have to get involved,” Springer said. “Show me the ROI.”
Not only do health care providers have to report more quality measures, but business decisions are increasingly becoming tied to both margins and clinical outcomes. Regulations demand more data points be reported, and those outcomes are oftentimes tied to reimbursement.
“From a regulation perspective, there are probably 300 quality measures, and more are coming,” Springer said. “That’s impossible to manage by any one provider.”
This maze of data means that integration is quickly becoming the name of the game.
“There’s nothing uglier than health care data,” he said. “All systems have different data, and you’ve got to make sense of it.”
Business Features in Data
While IT systems in the past have largely focused on gathering data and have become adopted by health care providers as regulations mandate, demand for coordinated care means technology must also integrate business goals and features that go beyond clinical data.
For example, a chief medical officer who is thinking about clinical outcomes from a coordinated perspective needs IT to support that.
“[A CMO] needs a way to engage with other providers, engage patients,” Springer said. “In a fee-for-service world, they don’t think about shared savings decisions. They need a data strategy and analytics strategy that supports that.”
Written by Amy Baxter