By Rohan Kulkarni

Has the industry agreed on a definition of population health management yet? Population health management may not be something we can specifically define or “put into a box.” Rather, it’s simply the way we should deliver healthcare.

Rohan Kulkarni

“The Health Evolution Summit provided a terrific forum for healthcare leaders to get closer to answering important questions on population health management.” –
Rohan Kulkarni, vice president of Healthcare Strategy and Portfolio for Xerox

That’s one of the insights my colleague, Tamara StClaire, gleaned from a deep dive session at the Health Evolution Summit. This session, “Population Health Management 3.0: Better Health + Higher Profits,” included a fantastic group of panelists:

  • Dr. Rushika Fernandopulle, founder and CEO of Iora Health
  • Dr. John Mattison, CMIO of Kaiser Permanente
  • Susan DeVore, president and CEO of Premier

I was part of an audience of executives, innovators, policymakers and investors shaping the future of healthcare. Here are the main takeaways and insights we heard at last week’s summit.

Back to the original question, our panelists agree that population health management is a proactive approach to improving health and keeping individuals healthy. At Xerox, we describe it as the management of health outcomes of a defined patient population through technology and services with the intent of achieving better health outcomes, patient experiences, and cost savings. Clinical, para-clinical and administrative services are each important to the overall picture and enabled by technology and analytics.

PopHealthMgmtDef

What are the primary challenges to meeting the financial and health outcome goals of this generation of population health management programs?

To help financial and health outcomes, we need to take a “whole patient approach.” Clinicians need to be proactive with patients at each encounter, with particular attention paid to social determinants as a guide. For instance, evidence-based care can allow a physician to connect a complaint of knee pain to the possibility of colon cancer or kidney issues. With this understanding, a physician can recommend a CAT scan after a patient complains of knee pain, and help ensure an early diagnosis.

Spending time talking with and listening to patients to understand their goals, and customize treatment to each individual, is critically important. But scaling this time-consuming effort is a challenge.

Where are the solution gaps and which players are best poised to fill those gaps?

While the title of our session included “population health management 3.0,” we may not be as far along in the evolution of the practice as we think we are. Our panelists agreed that while there are many  point solutions available to address specific problems, few integrated solutions focused on fixing the broader issues exist.  From the Xerox perspective, we advocate integrating the use of analytics, clinical, technology and administrative services as the best approach to take.

Which business models are gaining traction to advance population health management goals – or what new business models should be introduced?

One contentious question is whether fee-for-service and value-based-care models can coexist in the same environment. While some believe it’s necessary to combine these models, others believe population health management is counter to fee-for-service practices, and we need to make significant investments to make the shift.

For instance, we may need to introduce some form of risk adjusted capitation, wherein healthcare providers are paid a designated amount for each enrolled patient. The industry may also need to consider providing payment for non-clinical interventions to encourage preventative care.

In this period of transition and transformation in healthcare, it’s critically important that innovation happens in collaboration with physicians to ensure successful adoption.

It’s clear that there are still questions surrounding population health management, and the Health Evolution Summit was a great forum for industry leaders to come together to get closer to having clear answers for those questions. Many thanks to Dr. Rushika Fernandopulle, Dr. John Mattison and Susan DeVore for joining us for our conversation and providing their invaluable insights.