The author, James A. Hester, a participant in the IOM Roundtable on Population Health Improvement, calls for healthcare stakeholders to develop payment models that reward multiple aspects of population health improvement, not only preventive care. He notes several challenges for developing such a payment model, including limited defined metrics and validated interventions for population health.
If leaders do not overcome these challenges, however, they may miss the opportunity to incorporate population health incentives in new reimbursement structures developed under healthcare reform, according to Mr. Hester. “The threat is that while we are learning how to pay for health, the payment system will reach a new equilibrium that does not include a meaningful population health component,” he wrote.
He suggests raising awareness of the need for population health payment models, speeding the development of tools to support such payment models and encouraging pilot tests. CMS’ state innovation model awards as well as other public and private organizations should test population health payment models, he wrote.
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