The US healthcare system has some ways to go to show really successful outcomes of its population health system. This revelation is part of the 2015 Study from the Commonwealth Fund. The study titled ‘U.S. Health Care from a Global Perspective’ details the expenditure, prices and health care system across 13 countries and points to some startling facts.
Primarily, these facts state that the US has worse outcomes or results when compared to the other countries despite the fact that it spends more on health care. This is even more alarming when one thinks of the fact that the U.S. spends more on Health Care thanks to the use of cutting edge medical technology as well.
There are several questions that arise due to the findings of the study and if one were to look at population health analytics then a gap exists between the lessons from public health management and population health in the larger picture.
Experts state that the U.S. has a lower life expectancy despite spending more on healthcare simply because it has yet to apply the concepts or framework of public health to chronic disease management. Whereas, in countries such as Norway Germany and France, the outcomes of population health management are better because they are more cost effective and have taken lessons from the public health Care System as well.
The debate now is focused on how population health management can move ahead and improve its results as well.
One of the biggest attention areas is the fact that healthcare delivery systems do not, traditionally, take into account social determinants, economic factors and socioeconomic aspects. Whereas public health systems not only face these issues but also incorporate them into the framework.
It has become imperative for health care delivery systems in the US to add health care professionals from the public health domain to its framework. Undoubtedly, public health strategies are changing because they are incorporating value rather than ‘fee for service’ but it still has to include the many social determinants of health as well.
The model for population health solutions today is all about encounter-based medicine. Margins in such a system are managed on a PMPM basis – per member, per month. This approach is also present in the revenue cycle software and claims processing systems.
One of the biggest results of such an approach is a diluted relationship between care providers and patients. When the country moves towards a holistic health management approach, it will surely result in organizations investing a lot more care and attention in their patients. Such organizations will also take one step further and measure exactly how their investments are changing the help of the patient.
Experts are also talking about the equation behind population health and returns on the engagement between the system and highest risk patients. Essentially, this equation addresses the costs of population health management in order to increase of patient’s clinical outcome.
It stands to reason that analyzing and understanding the relationship between patient outcomes and costs is going to be the linchpin in the success of population health strategies. Simply put, a successful strategy is one that uses the investments and enhances clinical outcomes.
A two-step approach to population health can help – first increase the healthcare system’s capacity to manage not just bonded payment models but also risk based contracts. Second, strengthen health systems with stronger care management tools which focus on encouraging the patient to be an active participant in his or her own health as well.
Such a change will involve the right kind of software and professional services and integration across local and regional data that can pertain to specific patients.