Population health management becoming more common
CHICAGO – Since the Centers for Medicare & Medicaid Services launched the Physician Group Practice demonstration for Medicare patients in 2006, population health management has grown exponentially.
Today, there are more than 400 Medicare accountable care organizations(ACOs) and nearly 300 private ACOs, according to Joseph Damore, vice president of population health management at Premier. Damore spoke on Monday at the American College of Healthcare Executives’ Congress on Healthcare Leadership.
“This movement is really picking up steam,” he said.
Damore said hospitals are concerned about moving to population health management because it decreases healthcare utilization and revenue. However, he said hospitals must integrate new care and payment models and must shift to value-based compensation instead of traditional fee-for-service payment.
“The (value-based care) model is not flawed,” Damore said. “We believe there are execution problems.”
Damore defined population health management as the coordination of care delivery across a population to improve clinical and financial outcomes through disease management, case management and demand management.
He said an average of 10,000 people would turn 65 every day over the next 19 years, while 6,900 people will die every day during that same time period. Thus, there has been a shift to managed Medicare to control costs. In January, the Department of Health and Human Services announced new payment models for Medicare and said it would continue to shift away from fee-for-service.
All 32 ACOs participating in the Pioneer program achieved quality improvements in 2012, while two-thirds achieved cost savings, according to Damore.
There is also a trend toward bundled payments, a reimbursement model that covers multiple healthcare services within a specific episode of care for a negotiated price. Damore added that direct contracting is becoming more popular. He cited an Aon Hewitt survey that found 11 percent of employers were engaged in direct contracting in 2014 and 28 percent expected to do so within the next three to five years.
Executive Editor
Tim Casey joined TriMed Media Group in 2015 as Executive Editor. For the previous four years, he worked as an editor and writer for HMP Communications, primarily focused on covering managed care issues and reporting from medical and health care conferences. He was also a staff reporter at the Sacramento Bee for more than four years covering professional, college and high school sports. He earned his undergraduate degree in psychology from the University of Notre Dame and his MBA degree from Georgetown University.