Taking the First Steps Toward Managing Patients’ Health

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Thursday, 27 February 2014 01:04

Population health management plans are an important step if simultaneously improving quality, lowering costs and increasing patient satisfaction. For physician offices and smaller heath organizations, the impact on the business and on the patients can make a tremendous, positive impact.

Traditionally, we have viewed health care as providing care to the sick, not necessarily managing health. It’s important for both health care professionals and patients to play active roles in the process. Unrealistic expectations of patients such as “You need to lose 50 pounds in the next three months” will often backfire. Since patients trust their doctors, beginning the process together increases the likelihood of success.

It doesn’t take complicated systems or a team of consultants to begin to manage your patients’ health. Some of the first steps are back office: improving office efforts to determine insurance eligibility and payer requirements and checking your technology for interoperability with other health care organizations.  Begin or continue your efforts on improving clinical documentation which also prepared for ICD-10, and taking steps to comply with insurance claims processing and collections to limit denials.

The next step is to increase your capability to effectively manage patient health. Rather than trying to work with every patient, start with those who need the most help and provide the most opportunity. Use analytical tools to identify high-risk patients or those who are likely to become high-risk. Examine your care delivery model to determine if it fits with the patients you see and the market conditions you are experiencing.

Data management can and will continue to play an important role in population management. At its most basic levels, it can help you see how people access and use heath care in your practice through utilization data. Adherence data will provide insights into whether or not patients are complying with care and medication plans as well as preventive care measures. Operational and financial data can help better understand program participation, productivity and the impact on the bottom line.  Finally, satisfaction data can show how patients are evaluating your efforts.

PHMs can be delivered in many ways outside the office, through basic initiatives such as printed patient education materials, phone calls and websites. Additional support can come through patient portals and smartphone applications.

Results for PHMs are significant.  Research in the 2012 HPHM Healthcare Benchmarks showed that PHMs can increase  compliance (69%) and medication adherence (61%) while reducing hospital admissions (61%), hospital readmissions (58%) and ER visits (55%).  Regardless of how you start, there is value in beginning a program now for both you and your patients.