Healthcare is a topic that has inspired serious debate over the last few years. However, one of the few points on which nearly everyone can agree is that the treatment of chronic conditions like diabetes and obesity is costly and puts a strain on doctors and hospitals. In fact, the Centers for Disease Control report that more than 75 percent of healthcare spending is on individuals with one or more chronic conditions. One way in which the medical community is attempting to address this growing problem is through population health management.
Medical professionals define population health management differently. Most agree its goal is to deliver care in a safe, clinical, and cost effective manner through the application of strategies and interventions to defined groups. The system is driven by raw clinical data collected from patient records. Doctors use the information they collect in order to identify and treat patients before they require acute care.
The principles of population health management seem abstract to anyone outside of the medical community. Experts often use the case of type II diabetes to illustrate the concept. Payers, providers, and government organizations all have reason to be concerned about this chronic problem. The condition affects approximately 25.8 million Americans, or 8.3 percent of the population. Approximately 7 million have not been diagnosed. Additionally, approximately 79 million Americans have pre-diabetes. This condition is the seventh leading cause of death in the US and is the leading cause of kidney failure, limb amputations, and new cases of blindness.
Controlling the costs associated with diabetes involves managing the disease. Management requires the use of measurable data, such as hemoglobin A1c levels, weight, carbohydrate intake, and exercise. Medical professionals can employ these techniques with diabetes patients by establishing an enterprise data warehouse and applying analytic tools. The data collected can be used to find patients who are not up-to-date on tests, identify the patients at highest risk for high cholesterol, hypertension or heart disease, identify patients who may benefit from outreach, and measure the success of interventions.
Population health management also plays a role in reducing employer costs. The Affordable Care Act allow employers to offer incentives to employees who participate in early detection, prevention, or wellness programs. Hospitals and employers can work together to collect data in order to target employees with a preventable condition. Employers can offer coaching or incentives at work in order to encourage employees to participate. Cash bonuses, a reduced insurance premium, or a larger contribution to a health savings account can all be offered in order to encourage employees to make lifestyle changes, undergo screenings, or visit primary care physician on a regular basis.
Regardless of one's opinion on the state of the American medical system, everyone should agree that the system is better off when preventable, expensive diseases can be treated early. Population health management engages stakeholders to work together to improve individual wellness as well as the system as a whole.
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