One word, two meanings: Public health researchers push for clarity in talking about “population health” and ACOs

One word, two meanings: Public health researchers push for clarity in talking about “population health” and ACOs

 Are responsible care organizations really rising population health? consistent with 2 public health and policy researchers within the March twenty issue of the Journal of the yank Medical Association

Are responsible care organizations really rising population health? consistent with 2 public health and policy researchers within the March twenty issue of the Journal of the yank Medical Association, that depends on whose definition of “population health” you utilize.

The well-known goals for ACOs ar to regulate health care prices, improve quality in health care and improve population health, Dr. Lawrence Casalino and Dr. Stephen Arnold Douglas Noble from the Department of Public Health at Weill Cornell Medical faculty write within the article.

In the context of the Patient Protection & cheap Care Act and also the Centers for Medicare & health care Services’ rule for ACOs, population health refers to a health care organization’s pool of Medicare beneficiaries. And ACOs appear to possess taken their population health responsibilities that means, too, as preventive care to any or all patient and care management for patients with chronic diseases.

This is a significant discovery from the model of the past, said Noble, a visiting scientist from the united kingdom below the Commonwealth Fund’s Harkness Fellowship program. “ACOs do a really radical factor that is moving aloof from doctors solely considering what they'll do for patients once they’re before of them,” he told ME in a very phone interview. “That’s a huge factor for Americans, and I’m very affected with it.”

But the authors propose that the term population health is oft employed in a context additional closely associated with public health, and that’s a context within which ACOs aren’t furthermore poised to succeed.

“Population health is brooding about any range of individuals living in a very geographic region – it may be a county or a state – and every one of the services obtainable to them, and a part of that might be prime quality health care while not a doubt,” Noble aforementioned. however it additionally implies factors outside of the medical realm, like social services, the general public health system and socioeconomic factors. Those ar areas wherever most ACOs lack the incentives and capabilities to act effectively.

The authors argue that talking concerning ACOs therein context results in a “lack of clarity concerning what ACOs do ar concerning population health and will divert attention aloof from social and public health services and from socioeconomic factors vital to health,” they wrote. “It’s not simply a linguistics issue of very little importance if ACOs ar represented, or self-described, as operating to boost population health once what they're very doing is rising treatment for his or her own patients.”

A model that integrated that broader definition of population health would be additional of associate responsible care health community, wherever ACOs would work with different organizations to boost the general health of a precise geographic population.

Whether that’s one thing ACOs might or ought to eventually be able to do may be a whole different issue. however the sole means we’re attending to be able to have that discussion, the authors say, is that if we have a tendency to build a transparent distinction between population health in and out of the context of ACOs once formulating health care and work policy.

On that note, maybe the authors would be fans of the U.S. Agency for health care analysis and Quality’s idea of “practice-based population health.”

Source: medcitynews,com
Four healthcare trends to watch in 2014

Four healthcare trends to watch in 2014


2014 can still be a year of transformation because the implementation of the reasonable Care Act and therefore the changes it represents ripple through the aid trade. From conversations with aid suppliers across the country, Vree Health has known four key problems suppliers face within the returning year–and on the far side.

1. aid compensation is due for a boot

Healthcare systems, hospitals and suppliers area unit caught between 2 wide divergent business models: fee-for-service versus pay-for-performance. whereas captivated with the previous, they have to reconstitute their businesses to boost quality and manage prices across the whole care time to arrange for the latter. It’s associate concerning face that Dr. David Nash, institution Dean of the President Jefferson college of Population Health, likened to turning associate carrier around within the shipway, once he spoke at MedCity CONVERGE last year.

Consider the challenge:

Fee-for-service rewards billable infrastructure and man hours, whereas pay-for-performance rewards efficient potency.
Fee-for-service rewards in-house capabilities. Pay-for-performance rewards community cooperation.
Fee-for-service rewards failure. Pay-for-performance rewards results.
Straddling each models is reminiscent of Van Damme’s epic split during a recent Volvo Truck commercial–in alternative words, just about not possible while not steady hands at the wheel.

Immediate pressures for modification in 2014 can return from:

The Centers for Medicare & Medicaid Services (CMS) conceive to expand the amount of services that area unit reimbursed through bundled payments
Another CMS proposal to scale back the grading codes for the complexness of visits from this 5 to 2, thereby incentivizing suppliers to forestall complications
And be careful for the sleeping large of the states, United Nations agency can before long cowl, directly or indirectly, nearly third of all Americans. PriceWaterhouseCoopers estimates that twenty six states can have managed care programs to assist contain Medicaid prices in 2014. Innovators just like the Geisinger Health System understand that if states place their muscle behind fee-for-value, it'd be transformational.

The Takeaway:

Smart suppliers can specialise in aid consumers’ needs—patients and payers alike—to build new models of care that deliver most price.

2. aid technology can facilitate drive connected care

All of those changes in payment structure advance a extremely integrated aid system. Spurred by the HITECH Act, the adoption of electronic health records (EHR) in acute care hospitals quite tripled between 2009 and 2013. Now, aid organizations (HCOs) should hinge upon these systems to interrupt out of their four walls and integrate with the whole community to:

Connect with suppliers
Connect with patients
Connect with populations
Health system and money dealer partnerships, like the HealthShare Exchange of Southeastern Pennsylvania, represent one step toward connected care. it'll enable insurers and aid suppliers to share discharge history and medicine info with patients’ physicians to boost care transitions.

Meanwhile, meeting the necessities of pregnant Use (MU) Stages 2 and 3 remains a pressing reality for several HCOs. Proactive organizations can aim to create a technology platform that not solely meets the letter necessities, however additionally enhances the patient expertise. the look and practicality of patient portals is crucial. To achieve success, they have to actually have interaction and empower patients to move participants in their own care.

Finally, as we have a tendency to steer toward population health management, the worth of aid information will increase exponentially. HCOs should focus on HIT systems that modify them to combination and analyze information from disparate sources to spot best practices for up care quality and population health.

The Takeaway:

Maximize the worth of knowledge with open-ended technologies that integrate with the whole spectrum of patient-provider bit points–mobile health apps, telehealth and medical devices–to produce a consumer-friendly health and wellbeing scheme.

3. Growth of responsible Care Accelerates

ACOs, or responsible care organizations, area unit one amongst the underpinnings of health reform. ACOs currently serve quite five.3 million Medicare beneficiaries, and lots of alternative patients area unit served by non-ACO organizations deploying similar methods.

We expect the expansion of those systems to continue in 2014 as health reform drives toward integration. Innovative aid IT solutions and effective use of health information across partnering organizations—and even caregivers and patients—will be crucial to responsible care’s success in reducing the operational and monetary inefficiencies that plague our current system.

Especially vital are going to be new models of care that modify aid suppliers and patients to attach and collaborate on preventative (rather than reactive) aid problems, like blubber and polygenic disease. New digital health tools—whether social, mobile or cloud-based—may play a big role in patient engagement and adherence. group action patient goals and private health tools into treatment regimens is important to the evolution of a very patient-centric aid system.

The Takeaway:

ACOs should notice new and effective ways in which to interact, educate and encourage their patient populations to get entangled in preventative care.

4. Individual relationships with patients area unit more and more vital

In 2014, a lot of establishments can understand that patient-provider communication and relationships area unit crucial to economic success. consistent with a study within the Journal of family medicine, physicians United Nations agency score highest on measures of patient-centered communication incur lower prices in diagnostic testing, while not compromising health outcomes.

Innovative technologies give opportunities to create and expand the patient-provider relationship through personalised experiences with the potential to drive modification in patient behavior. it's at the purpose wherever patients area unit creating daily health choices that info, motivation and regular behavioural skills recommendation will produce a true distinction within the health selections they create. The manner patient relationships area unit managed throughout the care time could even influence patients’ ability to require management of their own health–a responsibility that too several patients these days feel unempowered to tackle.

Source: medcitynews,com