Value-based care (VBC) is an evolving challenge. Yes, it has been discussed widely. Some might even assume that healthcare organizations have reorganized around a concept of value that reduces healthcare costs and adheres to standardized quality measures to improve outcomes.
However, by and large, this is not the case. Despite its momentum, the movement toward VBC has been one of both slow progress and uncertainty. Nevertheless, the pace has quickened and the uncertainty has lessened through its convergence with population health management (PHM).
PHM is the system of care delivery and management designed around the health of specific populations, such as Medicare beneficiaries or individuals with chronic diseases. It has been a critical component of many of the realities observed in the healthcare industry over the past several years. From the growth of risk-based contracting through bundled payments and capitation, to the formation of accountable care organizations (ACOs) with the Centers of Medicare and Medicaid Services (CMS) and private payors, to the enactment of the Medicare Access and CHIP Reauthorization Act (MACRA), each development has centered on limiting the costs and ensuring the quality of care delivery for populations whose health has historically been the costliest to manage.
A concept that is often overlooked, but is a critical component of PHM, is population wellness—the process of proactively ensuring the health and wellness of an organization’s entire population, including both sick and healthy patients. PHM sets out to achieve the goals of VBC by emphasizing the delivery and management of care in a focused manner. Consideration of population wellness incorporates the act of identifying patients and delivering care before their health conditions advance—ideally, before they begin.
The shift to VBC has been a slow and nebulous process. However, the focus on PHM has hastened the journey by focusing the scope of care delivery and management on specific populations of patients. While there is no shortage of challenges facing healthcare organizations with PHM initiatives, technology and streamlined operations are being leveraged to make these processes more manageable and sustainable.
In order for healthcare organizations to make the transition to VBC, proactive efforts that also include the well must be a critical component of their strategies. Incorporating technologies that support population wellness will help healthcare organizations provide a more proactive approach to care and make VBC practices more sustainable over the long-term.
As a PHM technology company with a vision of enabling population health and wellness, we are focused on providing health systems and care teams with the technology and insights that support a more proactive and coordinated approach to care. Each day, as healthcare organizations shape their own paths to value-based care, we are transforming this concept into a reality.