A common term heard today by those of us that work in, or closely with the healthcare industry is population health. Population health is a term whose meaning today goes far beyond its literal definition. Wikipedia defines population health as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group. It is an approach to health that aims to improve the health of an entire human population”. Population Health has come to represent something much larger to many of us; a shift in who is leading and defining healthcare services. The current transition happening within healthcare affects all the players; but none more than the patients. This evolution is happening in healthcare now and goes beyond the government’s attempts to fix the processes. First let me define who the players are in the healthcare model:
· Payers are insurance providers: the institutions that can dictate which doctor or hospital we go to
· Providers provide care services to patients: they are typically doctors, nurses or institutions that
provide the care to us
· Patients are those of us that receive the care from providers
One of the key drivers of these changes, and the evolution to population health, is technology specifically and BIG DATA. Big Data and analytics are giving the payers and providers the information they need to create a more proactive approach to healthcare. I recently heard a CEO at a large healthcare software vendor state that it takes the healthcare industry 15-17 years for a 50% acceptance rate of a new innovation. If the lack of innovation is changing for the better, and I believe it is, it is in large part due to the Center for Medicaid Services (CMS) driving its change. CMS promoted the acceptance and implementation of technology through its Meaningful Use program. Meaningful Use, and now the Merit-Based Incentive Payment System (MIPS), offers providers monetary rewards for the implementation of certain technologies in predetermined time frames. The race for CMS Meaningful Use dollars seemed to change the mindset of healthcare providers as it relates to the adoption of new technology.
For instance, it was determined through data analytics that 20% of re-admitted patients, back for the same condition, had failed to have their first prescription filled from the initial stay. This has driven the development of technology that contacts and reminds the patient to fill his/her prescription through personalized email and text messaging. Additionally, Qualcomm and other technology companies have developed devices that can send home test information, such as blood pressure or blood sugar levels, with little or no setup from the patient. This data is transferred to the provider for immediate results.
The payers are getting into the act also. One large insurance company has stated they will set the same co-pay for a video call with a provider as one would pay for an office visit. This will create greater demand for video appointments, greater efficiency in regard to the use of doctors’ time and most importantly a better level of service to the patient.
Another recent and substantial disruption in healthcare services has been the presence of primary care type services in retail stores such as Walgreens and Kroger. Walmart is next to provide healthcare services; they have already stated they will approach it as they do all of their products and services, with the number one concern being the consumer. This not only provides the patient with more options but it also changes the way they view healthcare. Maybe healthcare is similar to other consumer goods: you can buy the cheap generic version for less money or spend more for a higher level of quality or service. If healthcare is to complete this transition to be a more patient driven model, the ultimate goal will be to let the market decide who the patient sees for their care. Ultimately, I think that is the final result for Population Health is allowing providers to be more efficient while patients to have more choices and a higher quality of care.
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.Jim Conwell (513) 227-4131 firstname.lastname@example.org www.twoearsonemouth.net