Based on what I’ve seen throughout my career, I couldn’t have imagined the speed at which certain markets have tipped to value-based payment models. There are parts of the country that seemed steadfast in their commitment to fee-for-service—and in as little as six months to a year, providers, payers, or in some cases a large employer, upended a market’s status quo and replaced it with an entirely new model.
For some health systems, market pressures to advance their efforts are getting in the way of strategic pacing and are leading to less impactful investments. Here are three ways to keep up the momentum without sacrificing results.
Accelerate change from the top-down
When evaluating organizations, we first look at whether they view population health as a mix of pilot projects. The problem with that approach is it won’t lead to meaningful transformation and will probably result in significant duplication and inefficiencies.
To stay on track for real impact, the system leadership—including the board of directors—must embrace population health management as a comprehensive strategy. Whether that means taking on financial risk today, or just creating a roadmap for risk in the future, there needs to be a top-down commitment to a brand new way of managing the network and caring for the patient. And with that high-level focus, a system can start building key relationships in the market with dominant payers or employers—so not to miss out on commercial contracts down the road.
Start with ‘no-regrets’ investments
Population Health Services
See how we can support your population health goals
My team finds that many organizations define their population health management capabilities by the amount of their business under financial risk. But the good news for system leaders is there are competencies and infrastructure pieces that don’t involve risk and have a positive impact in both fee-for-service and value-based care scenarios—what we call ‘no-regrets’ investments.
So before you put all your eggs into contracting, there are three things we’d argue you need to get right to manage population health and maintain and healthy ROI: Meet new access standards, reduce clinical variation, and keep patients in the system.
My colleague, Megan Clark, provided more detail about the significant financial benefits that these three capabilities have—but the financial impact goes even further.
These investments are so important, and they are ones that I’m particularly passionate about, because they can ultimately fund the economic transition from fee-for-service to an accountable payment model.
Prioritize your next steps through data
There’s one investment, which is really the key to pacing your population health strategy, that seems to be underfunded in provider systems—the analytic resources and technology to understand the underlying economics of such a significant transition.
A lot of organizations have the tools to stratify patients by risk-level and conduct analysis on the care management side, but can’t see, for example, how much patient leakage they have or calculate the impact of clinical variation. At the end of the day, it’s critical to monetize the infrastructure investments, know what’s actually paying off, and use that information to map out next steps.
With those financial metrics and a clear sense of ROI, leadership and the board of directors can have confidence in accelerating transformation and committing to real change from the top down.