Key Trends Behind the Growth of Population Health Management

WASHINGTON, D.C. — As the healthcare industry accelerates its transition from a fee-for-service model to a value-based one, population health initiatives will loom larger than ever throughout 2015, according to a new report.

One of the biggest factors driving the industry’s seismic shift is the Department of Health and Human Services’ announcement that it will tie half of Medicare provider payments to value-based models by 2018, a move President Obama has publicly supported.

Thus, “this year there is likely to be a dramatic shift toward the use of risk-based agreements and execution of population health management,” according to the report, produced by the Health Management Academy and Huron Healthcare following their 2014 Population Health Collaborative that culled insight from various experts and workshops.

This increased focus on population health will manifest itself in three key trends, according to the report:

• Increased organizational commitment to population health. This is most evident in the population-health spending increases that health systems plan for 2015, which, while not dramatic, indicate that they intend to devote a “significantly greater level of investment” to the subject this year, the report states. Furthermore, many healthcare executives expect a return on these investments within three to four years, FierceHealthcare has reported.

• More assumption of risk in the provider market. In 2014, the nation’s leading health systems conducted only 15{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of their business in alternative payment models, the report states, but the Health Management Academy expects there a shift of about 6{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} from fee-for-service to value-based revenues in 2015. The most common way providers plan to take on more risk is through commercial incentives, according to the report, followed by partnership with a health plan, bundling, full or partial capitation, and participation in an accountable-care organization.

• Better infrastructure to manage risk. The rise of electronic medical records has allowed providers to create and capture new data sources to manage the health of populations, but organizations need top-level buy-in as well as a strong culture of analytics in order to reap the full benefits of these tools. “The future of managing risk will be largely dependent on the ability of health systems to collect and synthesize large amounts of data into actionable improvements in care delivery,” the report states.