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Sticking to the basics: 3 essentials of population health management that are likely here to stay

April 24, 2017

    This is the second in a series of four posts focused on the role suppliers and service providers can play in supporting provider transitions to value-based care.

    In our last post, we identified why despite inevitable change in the health care market, the underlying drive for providers to deliver high-quality, cost-effective care is here to stay. But the question remains: Which care management imperatives will providers continue striving toward during the Trump administration?

    While it's not a comprehensive list, we've identified three essential goals we expect will remain.

    1. Expanding a robust primary care infrastructure

    Primary care consists of preventive health services and management of chronic conditions. One model of comprehensive care delivery is the patient-centered medical home (PCMH). While there are many definitions of this model, at its core a PCMH is a team-based approach to providing easy-access, comprehensive care in a way that engages patients. The integrity of the medical home infrastructure relies on advanced coordination among a diverse team of providers who work together to manage the health of their patient pool.

    Whether through a patient-centered medical home  or simply through improved access to a primary care physician, having a low-acuity entry point to the health system often makes the difference between patients receiving low-cost, upstream care, and high-cost, high-acuity, downstream treatment.

    2. Creating partnerships across the care continuum

    Beyond primary care, managing the cost of care across numerous sites is critical to improving quality and reining in overall health care spending.

    When multiple providers across sites of care treat the same patient, lack of communication and coordination can lead to duplicative and even conflicting care, and therefore excess spending. The Centers for Medicare and Medicaid Services (CMS) has introduced readmission penalties, bundled payments, and other payment innovation models to make providers more responsible for their patients' total costs of care. These programs incentivize providers to collaborate along the care continuum to minimize costs across an episode or a patient population. Many acute care providers have formed partnerships with post-acute providers or community health centers to enhance coordination and realize necessary savings to succeed under their financial incentive targets.

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