Now is the perfect time to advance the health of the people
We have an opportunity, an opportunity to adopt more equitable and efficient health care. In a world ruled by market forces, we cannot be constrained by the status quo and instead must move towards real lasting change in people’s health.
Population health – the identification and management of clinical and financial risk factors affecting a patient’s health – is the direction in which health care is heading and three key opportunities, innovation driven in the marketplace, horizontal care management and behavioral health transformation will enable this change.
Funding and regulation are the main indicators of the direction of health care. Private equity is geared towards innovative services that improve the health of the population. This can be seen as equity funding is pouring into ambulatory behavioral health, specialty pharmacy, telehealth platforms, home health services, remote monitoring services, and data integration technology. Not only do all of these technologies and services affect the health of the population, but many of them have traditionally been overlooked by health systems because organizations could not understand how these opportunities could be monetized. The enthusiasm that private equity firms have shown in taking on the initial financial risk of supporting new technologies enables healthcare systems to take advantage of healthcare innovation that was previously stifled by a lack of funding.
As the market evolves to support a population health future, we also need to consider how we can use these new innovations to strengthen managed care programs.
When you think of the management of care in a healthcare system today, it is really the management of care around several diseases. While these care programs are essential, on average they only provide support to a limited number of patients.
For example, if we look at patients who receive managed care in a typical American healthcare system – those with diabetes, congestive heart failure, low back pain, lung disease, or chronic kidney disease – and we add, these verticals of disease management only benefit 55%. of a given population.
Care management programs too often resemble disease management programs because the healthcare system has long focused on face-to-face billing related to specific illnesses. We need to change and reverse the management of care paradigm.
Let’s move from population health care management to more vertically oriented disease management programs to more horizontally integrated series of pathways, such as nutrition and weight management, exercise and physiotherapy, financial health. , preventive and palliative care, and behavioral health. Providing care management services tailored to these pathways would ensure that we reach 100 percent of the population instead of 55 percent.
Along each of these pathways are proven companies and tools, backed by private capital, ready to deliver value to patients and those who bear financial risk for needed care.
Finally, the greatest untapped clinical and financial opportunity in population health is the intersection of behavioral health and chronic disease. Behavioral health redefined is the greatest opportunity to curve the cost curve and improve chronic disease management outcomes. It is the missing piece for many of us in managing population health.
Failure to recognize and treat behavioral health, not as a mental illness but as a physical illness, is a huge mistake. For example, the total cost of care for a Medicare patient in Florida with diabetes is $ 12,000. However, if they have diabetes and unmanaged mild to moderate mood disorders, the cost of their care is approximately $ 28,000.
There is no more common thread in managing the health of a population, regardless of diagnosis, than better management of behavioral health. Private healthcare companies seek to evolve behavioral health management through digital engagements, identifying growing risks, and providing alternative care sites.
The health of the population is ultimately about the individual. Individuals in the population are either happy or sad, feel joy or pain, experience suffering and despair, and ultimately live or die. The individual. Not the population.
For individual patients, there is now a fierce urgency for providers to push relentlessly for comprehensive population health programs in health systems. For patients, the health of the population is not a theoretical concept. For patients, the health of the population is a hopeful reality. And now is the perfect time to take it forward.