America’s independent physicians met mid-March in San Antonio, Texas, for the 20th annual national meeting of TIPAAA – The IPA Association of America, the largest trade association serving independent and integrated physicians in the United States.
The focal point: population health, a relatively new front burner issue unfamiliar to many practitioners. Congress included the model as a component of mandates in the Patient Protection and Affordable Care Act (ACA) (See below).
“We covered a lot of ground at our annual meeting to educate independent physicians about population health,” said Al Holloway, founder and president of TIPAAA. “Once we fully understand what it is, then we’ll find tools, products and services that can assist independent physicians in their daily practice.”
One question that repeatedly popped up: What’s the difference between population health and public health?
“Some view population health as a more modern version of public health, which itself – improving the health of the public – may be a goal, a measurement system, and a conceptual framework that undergirds a profession and a scientific field,” wrote Michael A. Stoto, PhD, in “Population Health in the Affordable Care Act Era,” published by Academy Health (Feb. 21, 2013).
“Population health differs from public health, at least perceptually, in at least two respects,” Stoto explained. “First, it’s less directly tied to governmental health departments. Second, it explicitly includes the healthcare delivery system, which is sometimes seen as separate from or even in opposition to governmental public health.”
David B. Nash, MD, MBA, founding dean of the Thomas Jefferson University School of Population Health, pointed out that population health “builds on public health foundations.”
Among the building blocks, according to Nash:
Connecting prevention, wellness and behavioral health science with healthcare delivery, quality and safety, disease prevention/management and economic issues of value and risk – all in the service of a specific population. Examples: a city, provider’s practice, employee group, hospital’s primary service area or pre-school children.
Identifying socioeconomic and cultural factors that determine the health of populations, and developing policies that address the impact of these determinants.
Applying epidemiology and biostatistics in new ways to model disease states, map their incidence and predict their impact.
Using data analysis to design social and community interventions and new models of healthcare delivery that emphasize care coordination and ease of accessibility.
“When applied to healthcare delivery, population health differs from conventional healthcare by emphasizing value rather than volume of services rendered,” said Nash.
How will population health affect physicians?
Monumentally, said Kathy Jordan, president of Jordan Search Consultants.
“The primary care practice of the future will look much different than it does today,” she said. “Instead of one-on-one encounters between the patient and their provider, the patient interaction process will include phone visits, email consultations, group visits, education programs and encounters with a variety of care team members. Out-of-office contact will become the new norm as patient health improves. Additionally, primary care physicians of the future must exhibit leadership and interpersonal skills, as well as a passion for top-tier service delivery. How well they manage the team will directly translate to how well the health of their patient population is being managed, which will directly impact future compensation models.”
Important financially: To be eligible for incentivized government funding, organizations must prove their commitment to, and implementation of, population health, said Jordan.
“They’ll be required to improve the patient care experience, the overall health of populations, and lower per capita costs of case,” she said. “As a more comprehensively integrated system focused on population health begins to dominate, the healthcare industry, healthcare experience and provider recruitment initiatives must also evolve.”
Enter population health management.
Regina Levison, vice president of client development for Jordan Search Consultants, said that “while population health is defined as the health outcomes of a group of individuals comprising a specific demographic population, population health management is a business model centered on the delivery of comprehensive care and management of total risk.”
The foundational shift in the healthcare experience will morph from an industry driven by reactivity to an industry driven by proactive measures, said Levison.
“The goal of population health is to keep a patient population as healthy as possible and minimize the need for costly interventions, procedures, emergency room visits, and hospitalizations,” she said.
As an increasing number of healthcare organizations move to models of accountable care, the overall healthcare experience will be reconstructed, said Jordan.
“Within this transformation, we’ll see an altered patient and physician experience,” she said. “With an emphasis on proactive preventative care, evidence-based protocols, managed care teams, care coordination, and multidisciplinary teams, population health management will reward value in care, versus volume of patients seen.
“Although the results of these initiatives won’t manifest for a decade or more, population health management will almost certainly improve the quality of lives for millions of individuals throughout the country.”
The ACA and Population Health
The Patient Protection and Affordable Care Act (ACA) addresses population health in four significant ways:
Provisions to expand insurance coverage target the advancement of population health by improving access to the healthcare delivery system.
Other provisions seek to enhance the quality of care delivered.
Lesser known provisions aim to improve prevention and health promotion measures within the healthcare delivery system.
The final set promotes community- and population-health based activities, including the establishment of the National Prevention, Health Promotion and Public Health Council, which has already produced the mandated National Prevention Strategy and Prevention and Public Health Fund for monetizing Community Transformation Grants.
SOURCE: Academy Health.
