3 Elements for Advancing Population Health Strategies

3 Elements for Advancing Population Health Strategies

As hospitals and health systems prepare for the future coming out of COVID-19, population health should be part of every organization’s strategy. Having been on both the provider and payer side of healthcare for more than 20 years, I’m bullish on the need to move to whole person care. At Hackensack MeridianHealth (HMH) our population health strategy is focused on providing patients the right care, at the right time, and in the right place. If we execute that approach successfully, we ultimately improve our patient’s quality of care and the life while lowering medical costs.

Controlling more of the premium dollar

It is essential for provider organizations to develop a viable financial strategy that enables greater control of the premium dollar through collaborative win-win contracts. This can range from taking on downside risk in payer contracts to owning your own health plan. At HMH, we recognize that most of our revenue comes from fee-for-service and shared savings arrangements today, but we are on a path to take on more value-based contracts and shared risk in the near future. As care moves out of the inpatient setting, we must be prepared to support the patient’s entire journey while managing quality and costs.

Clinical and operational transformation

Clinical transformation is essential to enable our providers to deliver the highest quality care while managing medical costs.

"It is essential for provider organizations to develop a viable financial strategy that enables greater control of the premium dollar through collaborative win-win contracts"

Our clinically integrated network, Hackensack Meridian Health Partners, is our organized physician network with approximately 4,600 participating physicians serving more than 371,000 at-risk lives. We needed to establish the right operating model for us to be effective in driving system and practice change. So we partnered with Lumeris to implement an effective leadership and governance model, appropriate value-based physician compensation models, and physician scorecards to communicate performance transparently and encourage best practice sharing.

Simultaneously, our care transformation strategy embraces caring for the patient across the continuum. With our centralized care coordination staff, coupled with practice transformation efforts leveraging both HMH and Lumeris in-market resources, we can better follow the patient journey and ensure the right care. In addition, we are piloting a community health program to tackle social determinants of health and drive whole-person care.

The right technology to enable your population health strategy

Data is only useful if you make it credible and actionable. Like many other hospitals and systems, we have numerous data feeds and tools across our system, and we must ensure that the information can drive better care. Our work with Cerner and Lumeris, through their Maestro™ collaboration, is helping us do just that. We integrate EHR (including data from Epic and others), claims, lab, pharmacy and other relevant data from soon to be more than 100 clinical data sources, into our central data warehouse in Cerner’s HealtheIntent for aggregation and normalization. Then we push predictive analytics and actionable insights from Lumeris into our Epic EHR platform where it’s easily accessed by our care team. The care team leverages this data, with the support of Lumeris, to identify patients with rising risk and open care gaps in need of the right interventions.

With this holistic approach to value-based care—a progressive risk contracting strategy, focused clinical transformation, and the right technology infrastructure and operating model—we can capture the full picture of our patients and take action across the entire population.

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