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Saturday, April 2, 2016

Improving the Health of the US Population through Population Health




Finding a way to contain healthcare costs while improving the health of the US population are topics being discussed in the halls of Congress, in Board Rooms, in local communities and at national healthcare conferences across the country.  This is because the high cost of healthcare spending is threatening economic status of the United States around the world. 

Today it is recognized that chronic medical and mental health conditions are responsible for 75% of all health care expenditures. If we as a country want to slow the rate of healthcare spending, we need to work together to better educate consumers to change behaviors to prevent chronic conditions and empower them with tools and resources to better managed these conditions that will also improve their quality of life.

We all know that the United States spends more on healthcare than any other country in the world, but year after year, reports from organizations like the Commonwealth Fund show that we are not yielding commensurate value for those dollars in terms of population health or the patients’ experiences with the healthcare system. As a result, Federal and State governments, payers, providers, employers and consumers are learning the importance of working together to change this dynamic.

A few weeks ago, I attended the Population Healthcare Colloquium, a national meeting focused on population health. The Colloquium is now in its 16th year of bringing together leaders from various sectors of the healthcare industry to learn, network and share ideas on how to improve the health of the US population.

 The Conference is hosted by the Jefferson School of Public Health under the direction of Dr. David Nash. Dr. Nash is a passionate medical professional who uses his experience, insights and passion to design an event that year after year sets the agenda for the population health industry.

I have attended this conference almost annually since it started and always learned something new. The information presented assists professionals involved in population health to look at different viewpoints concerning health and wellness. This year’s event was extra special for me, as I missed last year’s Colloquium due to my illness, so I was looking forward to attending this year’s meeting.  I learned a great deal and was able to re-connect with colleagues and friends. The conference also enabled me to network with interesting exhibitors and learn about the innovative tools and resources available to assist the population health community with improving the delivery of care.

Maybe because I am looking at healthcare through the lens of a patient these days but I felt there was a different tone to this year’s event from previous Colloquiums. To me, there was a more personal focus and a serious look at the root causes impacting our ability to improve the country’s health and wellness irrespective of the billions of dollars spent trying.

Many of the speakers focused their presentation on the social determinants that impact health and our ability to live well. As we know, there are many factors that come together to affect the health of individuals and their communities. Whether people are healthy or not, is determined by their circumstances and environment. It was learned that to a large extent factors such as where we live, the state of our environment, genetics, our income, education levels, and our relationships with friends and family, can have considerable impact our health and well-being.

The theme of several the presentations stressed that we as a healthcare team have to get back to basics and learn from our patients how they are faring with basic needs such as food, shelter and work status. One quote that struck me and drove home this point was; “the most important factor in determining a patient's chance of being readmitted to the hospital was what they have in their refrigerator!”  Meaning many patients are discharged from emergency departments or the hospital without being asked some basic questions which could alert us to the challenges they face. They include such questions as;  do you have a home, do you have food to eat that meets your nutritional needs, do you have a way to get your medication, do you have a primary care doctor who you can follow-up with, and do you have a way to get to a follow-up appointment? Depending on how patients answer these questions can determine how they will do with regarding to the management of their health care challenges. To me, these questions are a wake-up call as to the challenges patient and caregivers face every day. If we want to be able to change the status quo; we need to take the time to understand the basic needs that impact the health and welfare of the people whom we serve.

Today, it is recognized that sickness and the hospital-centric model of healthcare, is giving way to an "anywhere care" model that centers on population health management. Population Health Management goals includes better health, better care, lower costs and improved access to care and outcomes. A new leadership mindset focused on these four imperatives is needed to spur progress toward meeting the population's health. These imperatives are:

·       Committing to a New View of Healthcare; Healthcare professionals with this new mindset recognize that change is not coming to healthcare; it is already here based on consumer-driven and Internet-fueled choice. If consumers prefer the convenience and style of nurse practitioners in retail store-based clinics, then they will seek out the settings where they can have the nurse practitioners in retail settings. Consumers are bypassing expensive, inconveniently located facilities, preferring their care in places close to where they live, shop and work.

·       Building Agility: The role of today’s healthcare's leaders centers on building organizational agility. To be able to nimbly operate a current business while simultaneously preparing for changing/new conditions.

·       Experimentation and Innovations: The drumbeat for value has been present in healthcare for decades and is growing considerably faster and louder. Adoption or expectation of value-based payment has increased rapidly, with impetus from the Centers for Medicare & Medicaid Services, which announced its goal of moving at least 50% of its payments into value-based mechanisms by 2018. New payment models center around quality vs. quantity. Providers who want to succeed will have to be able to demonstrate the value they bring and the outcomes achieved to qualify for incentives and avoiding penalties.

·       Integrated Planning and a Blueprint for the Journey: To manage an environment all must be able to analyze market dimensions and develop and plan for multiple scenarios. They then must move ahead to make the fundamental changes needed in their organization's technology, system configuration, and clinical and business processes.

As the industry continues to move toward these changes, some organizations are testing new
models and showing success. To recognize and reward providers and organizations for their
work a new dimension was added to the Population Health Colloquium this year. The Hearst
Health Prize was introduced this year to recognize organizations doing innovative work in
the area of population health. The awards program was developed by the Jefferson College of Population Health and Hearst Health. 

I wrote about this exciting program in last week’s issue of Nurse Advocate. In my interview with Gregory Dorn, MD and president of Hearst Health, I learned that the call for submissions drew over 150 entries. Three finalists and one winner was chosen by a distinguished panel of judges. The award winner walked away with $100,000.00 which will help them further their project. The finalists were: Centering Health Care Institute, Wealth for Health; a program developed by Jersey City Medical Center and Community Health Care of North Carolina. Each of these programs showed innovation and the importance of how healthcare systems can improve the health of their populations through collaboration with their communities. The winner of the Inaugural Hearst Health Award was Community Care of North Carolina for the work they are doing with in improving care coordination and transitions of care in heir Medicaid population.

It is exciting for me to see the growth of the Population Health Colloquium from the standpoint of the number of professionals attending, to the wide variety of vendor participating, to the creativity and innovation taking place from all sectors of the healthcare community. I left the meeting thinking that concept of Population Health is taking hold and is on an exciting path of changing the delivery of healthcare while improving the health of populations across the country.

The 2016 Colloquium was presented live and via a live webcast. As a result, the event has been archived which allows you and your teams to view the program post event. Here is the link http://www.populationhealthcolloquiumportal.com for the cost and details on how to access.

Thanks again to Dr. David Nash and his team for another great conference. I look forward to the 2017 Colloquium and hope to see many of you there!