August 21, 2015 Regional Learning Session
Population Health Management: Why it matters, How it's done, What's next? Learning Session Objectives: • Why is greater population health management necessary? • What is population health management? • What are we learning about the value of population health from the unique perspectives of providers, purchasers, and consumers? • How can we support each other in taking the next steps to improve population health management in the Greater Columbus region? Featured Speaker •
Pamela Peele, PhD, Chief Analytics Officer University of Pittsburgh Medical Center (UPMC) Health Plan
Regional Panel • • • • • •
David Applegate, MD - Chief, Primary Care Transformation, OhioHealth Physician Group Arick Forrest, MD - Medical Director, Ambulatory Services, The Ohio State University Wexner Medical Center Tricia Schmidt - Client Advocate, Willis of Ohio Ben Shaker - Vice President and COO, Mount Carmel Health Partners King Stumpp - President and CEO, Netcare Access Bruce Wall, MD - Senior Medical Director, Aetna
Summary of Presentation Dr. Peele presented on the Population Health Management program implemented by the University of Pittsburgh Medical Center Health Plan. Using big data, the program has catalyzed changes in culture throughout the organization leading to significant savings. The program has also led to some unintended benefits such as employees having less unplanned sick days. Dr. Peele argued that although population health management requires a large investment, the long term benefit is well worth it. Due to UPMC policy, copies of the presentation slides are not permitted. Below is a record of learning from the presentation and panel discussion. Record of Learning • • • • • • • • • • • •
A one size fits all approach to Population Health Management (PHM) will not work. Although it will take a big investment to get our population on the “healthy frontier”, the benefit of doing so will be massive. Behavior and culture change across all stakeholders will be key to success. Can be difficult for specialists to focus on PHM, because they see patients in a very limited scope. Will be necessary for specialists to start working more closely with primary care providers. Making investment in to data system infrastructure is not sufficient, it will be important to have appropriate resources for data interpretation and insight. Focus on the whole family rather than the individual patient/employee. Important to take one step at a time. Needle won’t move very far if the program tries to “drink the ocean”. Incentives need to be aligned with PHM goals in order to be successful. Incentives should be shifted to encourage more students to pursue a career in primary care. Integrated systems are a huge step forward. Independents will have a hard time reaching true PHM. Part of the population may need close monitoring while other parts may just need the “system” to get out of their way. Teaching self-care in schools can lead to a big impact in the future. Premium and deductible differentials lead to the most impact. Patients and employees are rarely motivated by reward programs. Often times reward programs pay people to do what they were already doing.
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Loss and regret aversion approaches engage patients more than rewards. Program needs to evolve in order to have sustained impact. Return on investment will not be seen immediately. UPMC did not see any savings until year 3 of their program. Total cost of care is the most important metric for UPMC. If the quality of care is poor it will lead to a higher total cost. Who is ultimately responsible for PHM? Will require organizations to begin trusting each other and sharing necessary information. We need to change the way we see data. Incorporating additional household data with clinical data is important in identifying alternative predictive health patterns.
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Share-Learning Sessions Exploring key areas of the Population Health Management framework. •
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Information-Powered Clinical Decision Making Use robust patient data set to support proactive, comprehensive care Operate within an integrated data network Position a leader to merge data analytics within clinical care Primary Care Led Clinical Workforce Elevate PCP to “CEO” of care team Mobilize community workforce to extend care team reach Patient Engagement & Community Integration Map services to population need Overcome non-clinical barriers to maximize health outcomes Integrate patient’s values into the care plan Use community stakeholders to connect patients with high-value resources
Feedback from participants on value of August 21 Regional Learning Session • • • • •
Very High Value = 43% High Value = 39% Average Value = 11% Low Value = 7% No Value = 0%
__________________________________________________________________________________________________ Please save the dates for our scheduled 2015 Regional Learning Sessions October 7th Webinar, 1:00 – 2:00 PM Topic: National Quality Metrics December 4th Regional Learning Session, 8:30 – 11:30 AM Topic: Featuring Regional Healthcare Transformational Activities www.hcgc.org/registration