What is population health management?   Who is it for?   Why is it needed?

How does it improve health outcomes and reduce spending without compromising patient satisfaction or provider compensation?

All these questions we seek to answer in this short series. We attempt to make population health management simple. Whether one is deeply versed in healthcare IT, or seeking to understand how technology aids providers in new payment models, readers will be able to understand the components, strategies, and technology that encompasses population health management.

Introduction to Population Health

The pressure to reduce healthcare costs, improve quality, and implement value-based payment models has encouraged closer alignment among payers, providers, and patients. Population Health Management (PHM) is at the center of improving care delivery, lowering costs, and facilitating strategies for providers to better manage the health of the communities they serve. In order to prepare for this vast transformation, much is to be considered: changes that impact care delivery, physician compensation, and the way we leverage patient data. As we collectively advance into the era of value-based care, accountability for the health outcomes and cost of entire populations are vital to future success.

PHM strategies aim to increase health outcomes, improve financial performance, and increase the wellbeing of patient lives through the integration of...

Complete the form on the right to view the entire document.

Embracing New Strategies

Population Health Management (PHM) is defined as a business strategy for healthcare organization moving into value-based care models. The goals of PHM strategies include increasing health outcomes, improving financial performance, and enhancing the wellbeing of patient lives through the integration of data, patient care, and information technology.

Because the healthcare industry has progressively moved towards value-based care, new reimbursement structures and risk-based contracts are bringing new challenges that require a new set of tools to aid providers as they navigate the new world. Such tools include an Enterprise Data Warehouse, Risk Stratification, Cohort Management, Data Analytics, Care Management, and Patient/Provider Engagement. Before jumping into the details...

Complete the form on the right to view the entire document.

A Foundation Built for Success

The foundation for a successful Population Health Management (PHM) platform starts with an Enterprise Data Warehouse (EDW). An EDW serves as a unified patient registry which stores clinical, claims, social, and other data from multiple sources. When implementing population health strategies to manage value-based contracts, providers need a holistic view of their patient population. A holistic view is made of clinical, claims, social and all other data made available to the provider. Combining data allows the provider to...

Complete the form on the right to view the entire document.

Identifying Your High Risk Patients

The Lightbeam PHM Platform uses a two-method approach for organizing patients into different categories of risk. The first method assigns a Risk Score to each patient using the Johns Hopkins Adjusted Clinical Groups® (ACG®) System for Predictive Modeling. The second method utilizes the Lightbeam ATI (“Ability to Impact”) Score to distinguish patients with like Risk Scores. In the Lightbeam application, both the Risk and ATI Score are relative to the patient....

Complete the form on the right to view the entire document.

How to Care Manage Your "Right" Patients

Care managers support patients as they strive to achieve their health goals. Through health assessments, coordinating care, generating care plans, and monitoring services, these health professionals play a critical part in helping patients manage their own health. Care managers have a direct impact on helping reduce unnecessary spending and increase the quality of care for the health system. With the right tools, clinicians can quickly identify which patients....

Complete the form on the right to view the entire document.

Effective Communication Makes a Big Difference in Value-Based Care

In value-based care, engagement is a crucial step for inspiring behavioral change and informing care decisions. The number one goal in population health management (PHM) is to improve the overall health of the population being served. This goal is accomplished by maximizing actions and minimizing manual evaluation of patient data. In lesson 06, we will discuss the engagement methods for two major stakeholders involved in PHM, the Provider and the Patient.

Complete the form on the right to view the entire document.

Analytics - Descriptive vs Prescriptive

As the healthcare landscape evolves through regulation and consolidation, it seems the only constant is change. Executive and clinical leaders need solutions that can evolve and grow at a pace that meets or exceeds the rate of organizational change. As higher percentages of provider reimbursement fall within value-based models, population health management (PMH) solutions deliver the analytics and reporting necessary to achieve value-based clinical quality and financial objectives. Lesson 07 will discuss the importance of healthcare analytics, dashboards, and reporting capabilities.

Complete the form on the right to view the entire document.

Please complete the form below to begin downloading the Population Health Made Simple series: