Value based care and population health management

The Centers for Medicare & Medicaid Services (CMS) continues to emphasize the need for independent physicians to provide quality care that is reimbursed not on the basis of the quantity of patient visits but on the quality of patient outcomes. Many commercial insurance companies are following suit, emphasizing reimbursement for value-based care over individual visits.

A recent article published by the Healthcare Information and Management Systems Society (HIMSS) noted that “Population health management has been widely discussed as the solution to help healthcare organizations reach value-based care goals.” Additionally, the article states that “there are three keys to a successful program: data analytics, technology adoption and the inclusion of the patient as a partner.”

Population health management involves tracking data on individual patients within a population group. Healthcare IT News reports that the “concept of population health first came about in 2003 when David Kindig and Greg Stoddart defined it as ‘the health outcome of a group of individuals, including the distribution of such outcomes within the group.’”

The ability to manage data regarding the population can be a significant factor in the value-based care provided to those patients. HIMSS emphasizes that “real-time data enables clinical decision support which can help payers and providers address at-risk populations, and provide timelier interventions. Analytics help us find gaps in care and determine whether healthy outcomes were achieved.”

An electronic health record (EHR) solution enables the independent physician to holistically evaluate the patient population with a longitudinal record that trends vitals and lab values over time. Partnering with the patient to manage healthcare plans and medications improves the value of the care provided to that patient. In fact, most patients want to be more actively involved in decisions that affect their ongoing health.

Quality technology, data analytics, and patient involvement enable the independent physician to manage the population’s health to produce quality patient outcomes and to more successfully participate in value-based care.