DEFINING THE PHRASE: Population Health Management
As modern healthcare moves from a fee for service model to population health management, we will see some changes in the way service is delivered. One of the most obvious will be the integration of primary and behavioral health care.
Population Health Management (PHM) is the process of collecting and analyzing data on individuals from different segments of the population and utilizing insights from that information to treat whole segments of patients. PHM was developed to improve overall health outcomes of groups by using information collected by monitoring certain patients within that group.
The earliest mention of the concept can be found in a 1994 book by Robert Evans, Morris Barer, and Theodore Marmor named Why are Some People Healthy and Others Not?. David Kindig took the concept and further developed it in 1997, eventually partnering with Stoddart in 2003, to the concept that is utilized today worldwide. The idea of PHM hit the market in 2003 when David Kindig and Greg Stoddart developed the concept defined as “the health outcome of a group of individuals, including the distribution of such outcomes within the group.”
Goals of PHM
There is not a formal consensus amongst healthcare providers on what the goals of PHM are, so many organizations have developed their expected outcomes of implementing the new practice.
Nandini Rangaswamy, Executive Vice President and Chief Strategy Officer of ZeOmega, a healthcare IT company that helps healthcare stakeholders effectively collaborate, developed five pillars a successful PHM program should consider. The pillars are Program Design and Governance; Data Integration and Aggregation; Actionable Intelligence; Holistic, Patient-Centered Care Management; and Consumer Engagement. Rangaswamy states that organizations that successfully implement these five pillars “…will be best positioned to thrive in a value-based care environment”.
How PHM is working today
Effective PHM has proved to be beneficial to patients, physicians, and healthcare organizations.
- Better coordinated care
- More engaged and better equipped to manage their own health, from preventive care to chronic conditions and disease.
- More timely and preventive care also mean cost savings
- Better informed which means that they are seeing better outcomes in care
- The focus on engaging patients and providing better, more coordinated care also help them satisfy quality measures for patient engagement
Health Plans and other Healthcare organizations
- Increased profits regardless of payment model, as gaps in care, are filled
- Increased patient volume
- Care delivered more effectively and efficiently
- Overall lower costs as care improves and engagement grows
The Bottom Line
Every stakeholder in the healthcare system stands to benefit from PHM. From increased preventative care, which helps avoid more expensive procedures, to higher quality, more efficient, coordinated care including more integration of physical and behavioral health care. Reduced overall healthcare costs, better management of diseases, and a healthier, more satisfied population.
About Behavioral Health Professionals, Inc.:
Established in 2002 and headquartered in Detroit, Michigan, BHPI is a Managed Behavioral Health Organization offering behavioral health services through a fully integrated network of world-class healthcare providers. Our emphasis is on adding value for our customers by offering expert behavioral care management, medical coordination, and behavioral disease and chronic behavioral condition management. BHPI offers collaborative solutions by building strong partnerships with health plans, health systems, community mental health organizations, and employer groups. For more information visit:BHPI.org