Michael Dowling: How to make population health a robust strategy — not a one-off project

To effectively manage population health, related initiatives must be central components of a health system's overall strategy. They cannot be one-off projects occurring on the sidelines — not if the organization hopes to maintain an energized workforce and succeed in the value-based era of healthcare.

The growing momentum behind population health management represents a marked departure from traditional healthcare, in which providers saw patients when they were ill or injured, treated them and sent them on their way. At its core, population health management requires a fundamental reconstruction of our mindset as providers.

We must expand all of the metrics we use regarding quality — Did the patient get well? Did they recover and stay healthy after they were discharged? In a population health model, we must define metrics that are focused on prevention and long-term health improvement. It's not just about a patient surviving surgery; it's about his or her ability to return to an active lifestyle, rejoin the workforce and maintain a high quality of life.

There are various other tenets of an effective population health management strategy.

Investments in healthcare IT and data analytics are important, but not surprisingly, most of a strategy's success depends on clinicians and administrators who are on the front lines of delivering care. Education and engagement among clinicians and other frontline staff is absolutely critical to any change in healthcare delivery, and hospital and health system leaders must learn what it means to take on risk.

Northwell Health's Population Health Strategy

At Northwell Health, we've invested a lot of time and energy on guiding the cultural change necessary to support our population health goals. The prior episodic approach to healthcare will simply no longer hold up. We all must understand that social determinants of health — lifestyle, behavior and social circumstances — play a significant role in people's state of wellness. Some say your zip code could more significantly influence your health than whether or not you have a primary care doctor. The cultural shift is imperative because if providers don't know why they are being asked to make a change, it is hard for them to do so successfully.

To that end, we've created an Office of Population Health Management, a centralized department within our health system that coordinates all of our population health efforts. Within that office is CareConnect, the health insurance plan we launched in 2013 that now has more than 100,000 members, and a care management group called Northwell Solutions that coordinates the services we provide to those with chronic illness. We've participated in multiple government programs, such as the Medicare Shared Savings Program, the Pioneer Accountable Care Organization program, bundled payments and CMS' Independence at Home program.

We've also invested heavily in health IT and data analytics. It's imperative that clinicians have access to real-time information that allows them to connect to high-risk patients and share data about them with other caretakers. In addition, we've developed a robust telemedicine program, equipped with a call center, that enables patients to reach physicians faster and with greater convenience before their condition forces them to come to the emergency room.

When it comes to population health, the key is coordination. None of these initiatives function in silos apart from one another. Instead, they work together synergistically. If you just create a series of individual entities that aren't harmonized, you're going to have issues, especially in a large organization.

Get the Right Leaders in Place

Health system leaders can't expect their clinicians and frontline staff to learn what population health means and adopt an entirely new mindset if the leaders don't fully comprehend it themselves.

For instance, it's important to understand how taking on risk will affect reimbursement, and how poor performance in quality and the patient experience are detrimental for many reasons, including the financial consequence under risk arrangements. They must also be receptive to partnering with organizations that hospitals and health systems haven't traditionally partnered with, such as community organizations, skilled nursing facilities and home care providers.

Healthcare administrators in today's world must be prepared to lead a hospital without walls. If you have a hospital administrator focused only on what goes on inside the hospital, he or she is probably the wrong person to lead.

How to Gain a Competitive Edge

While we all say healthcare is local, most hospitals and health systems around the country are dealing with similar issues. We are all paying increasing attention to the patient experience, improving quality and outcomes, and increasing transparency, quality and price information. However, making your population health strategy unique from your competitors' will give you a competitive edge in your market.

While many health systems' high-level population health efforts aim to achieve the same objectives, health systems can stand out by how they implement them. This could come in the form of creating a health plan, participating in an ACO, investing in home healthcare, finding innovative community partners to team up with or other strategic initiatives.

Another way for health systems to get a leg up on the competition is through marketing. Northwell Health has created an entirely new marketing strategy since changing our name change from North Shore-LIJ in January. The new name underscores our focus on managing overall health and keeping people well, and is more aligned with the future of healthcare. Our marketing strategy, which we are unveiling over the next year, is focused on population health, innovation, creativity and entrepreneurism.

Our marketing team is intimately involved in our population health efforts, both within and outside of the organization. It's important not to overlook the importance of internal marketing, especially as it relates to educating our leaders and physicians. They are the experts in articulating our vision and goals, both to our staff and to the communities we serve.

Population health management is central to most organizations' core strategies, yet many leaders and healthcare providers have only a vague understanding of how it will truly affect the way they deliver healthcare. Successful population health initiatives not only seek to improve coordination among providers, address social determinants of health and forge innovative partnerships, they also emphasize the importance of staff education and cultural evolution. In the long term, investing time and resources in each of these components will yield the best results, both for the community as well as providers.



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