We spent the morning talking about innovations within Medicare’s payment innovation programs; this afternoon, we’ll explore care innovations in the private sector.
Our third panel focuses on a key challenge facing population health managers: scaling care management efforts.
Adirondack Medical Home Pilot
To understand where and why population health at scale poses such a challenge, imagine a geographic area about the size of Rhode Island, but with approximately 3% of the population: that’s the Adirondacks, a heavily rural area and the site of the Adirondack Medical Home Pilot, whose architects joined our panel.
Dr. John Rugge and Karen Ashline joined the Advisory Board’s own Dennis Weaver in speaking about their efforts to engage a multitude of stakeholders, including physicians, patient navigators, pharmacists, hospitals, and payers, to coordinate care and share best practices across a disparate and sparsely populated region.
Healthy Rhode Island
Rhode Island is one of 19 states to receive a grant from the federal government to identify a road map for moving 80% of its population onto a value-based care model in five years. The effort, titled Healthy Rhode Island, is mobilizing to move away from its siloed, provider- and payer-focused delivery system to one that is coordinated and patient-centered.
Daniel Meuse and Jennifer Wood, chiefs of staff in the office of RI Lieutenant Governor Elizabeth Roberts, spoke about Rhode Island’s efforts to ensure that government does not lag behind the private sector in health care innovation, and to identify a productive role for government in managing population health and bending the cost curve. Wood said that there is a role for state government either as a convener or stakeholders, or as a force in removing regulatory barriers to innovation. In Wood’s words, “we either need to lead, support, or get out of the way.”
When it comes to securing buy-in for population health management efforts, Dr. Lisa Bielamowicz asked the panelists how to deal with the inevitable pushback from providers about “not being kept whole,” and potential obstructionism as a result.
Jennifer Wood from Healthy Rhode Island answered that when she and her colleagues convene stakeholders to discuss this issue, “our opening gambit is that we are not seeking to create consensus; rather, we’re seeking knowledge to guide our decision-making.” Revisiting the theme that all efforts inherently create winners and losers, this panel offered an important response, and one that may help other decision-makers mitigate challenges from individual stakeholders.
The panel ended with another point on which all panelists seemed to agree: change takes time. Between establishing the IT infrastructure, convening disparate stakeholders, and creating and executing on a clear mission, these efforts take years to roll out successfully.
We’ll be posting dispatches from the National Population Health Symposium on this blog across the day, so stay tuned. For shorter, real-time insights from the Symposium, follow the hashtag #NPHS2013 on Twitter.