To understand population health management, it is important to first understand the concept of population health. Population health is the study of the health status and outcomes of a group of people rather than individuals. This is done to help those in the public health and medical fields understand how a certain population is doing medically and how they are being treated. The group is often, but not always, determined geographically. The study is on both the group members’ health and the distribution of health within the group.
Population health management is the process of focusing on a group of individuals within society and improving their clinical health outcomes. This process often involved naming and addressing specific health concerns within a certain population and developing an interdisciplinary and customizable approach to bring about change. Healthcare organizations partner with various other parts of society like academia, government, public health organizations and specific industries to achieve these goals.
The population of choice could be a number of sizes and based on several factors. There are a variety of subgroups within society with specific healthcare needs. Examples of population groups could be age, health condition, location, access to healthcare, gender, race and socioeconomic status.
Population health management has taken a front seat during the COVID-19 pandemic, as the disparity in health equity has been put on display, with so many needing access to various healthcare services.
What are the Financial Benefits of Population Health?
The ultimate financial goal of population health management is to minimize the current financial pressures that provider organizations and hospitals feel. One area of focus is expanding insurance coverage through a certain population group to relieve some financial burden on care providers.
The population groups being studied and helped will benefit financially as well. When communities receive inefficient healthcare, their financial contributions go to waste. This often means they have to return for more visits to a healthcare provider than they should have to, draining their funds. Effective healthcare is much more cost-efficient and financially feasible for the demographic population health management is trying to help.
It is important for healthcare organizations to invest in their services appropriately. Finding the balance between providing quality care and keeping costs low is tricky but essential to the process of population health management. The American Medical Association (AMA) has suggestions for increasing cost efficiency without decreasing the quality of care. These ideas are all-encompassing but could be applied on a smaller scale to your healthcare organization.
The High-Volume Approach
The idea of the high-volume approach is to decrease the cost of care to increase the amount of patients in the hopes that costs and profits will balance out. This approach is straightforward to the naked eye but comes with challenges. Higher patient volume means more strain on healthcare providers, making it difficult to provide quality care to each patient. It has been difficult to measure clinical outcomes holistically in contexts where the high-volume approach has been implemented, but it did seem to take a toll on long-term patient outcomes.
The High-Touch Approach
This approach focuses on the opposite goal of the high-volume approach in that it prioritizes patient outcomes. This approach takes longer to see financial results but believes that intentionality in care plans and behavioral change will ultimately lead to financial benefit.
A patient being cared for under this approach will get a lot of one-on-one attention from healthcare providers. Similar to the high-volume approach, there is not a lot of data on what the clinical outcomes of this approach are, but there is a difference in long-term patient outcomes.
Combining the Two
These approaches come with a unique set of benefits and drawbacks, but they have both proven to the degree that they can improve outcomes and reduce costs.
There is a unique advantage to combining the two. Especially through the lens of patient management, the point of utmost importance is how the population you focus on is best served. Different population groups require more or less of the two approaches. The most important thing is you’re tailoring to their needs. This is the best way to be cost-efficient in providing care.
How Does Population Health Differ From Public Health?
Public health takes a different approach to improving a community’s health than population health management does:
- Practical efforts: Public health focuses less on medicine and more on implementing policies, education and research. Population health is more medicine-focused.
- Prevention: Population health is more focused on caring for the ill, while public health incorporates an element of prevention efforts.
- Focus: Public health has a very wide, general focus. On the other hand, the whole point of population health is narrowing in on certain demographics and determining how to care for their healthcare needs.
- Government involvement: Public health efforts are subject to government regulation, while a healthcare organization normally initiates population health.
What are the Elements of Population Health?
Population health management takes certain elements of a population group into account. Each element has both a biological impact on the individual as well as an impact on the population health outcome.
Population health solutions are naturally population specific. This means one of the major elements of population health management is fully understanding the population group you are focusing on. Population groups can be determined based on a variety of demographic information, but the most common one is geography. Some other examples include age, gender, socioeconomic status, education and race.
Access to Healthcare
One major element to studying a population group is their access to adequate healthcare. This often goes along with their geographic location, which is why that is such a common demographic to study. There are a variety of smaller factors that go into this factor:
- Distance from hospital: Part of this aspect of study should focus on how far each part of your demographic focus is from the nearest healthcare facility, including hospitals as well as pharmacies and urgent care facilities.
- Financial implications: Another part of the study should focus on how accessible healthcare is to the demographic from a financial perspective. If the demographic is especially poor, is there access to a free clinic in case of emergency?
- Quality of healthcare: They may have access to healthcare, but is the quality of that healthcare high enough to provide them with quality care?
Biology and Genetics
Population health management requires information regarding the demographics’ tendencies towards various diseases, which stems from genetics. Studying genetics is also helpful if you focus on a specific disease and want to determine what is increasing the risk for certain people. This can help identify or eliminate some risk factors.
There are also simple biological factors to consider:
- Age: Older adults are prone to more medical conditions and other health issues than younger people.
- Sex: Men and women are more prone to different health conditions.
- HIV status: The pervasiveness of HIV makes it an important factor to consider when studying a population group’s health.
- Inherited conditions: Back to genetics, it is important to be aware of any inherited conditions common in your population group.
- Family history: Learning the family history of members of your population group can help you understand what they are at risk for and how healthy they are at a base level.
The quality of a person’s health is determined by a lot of external factors. A person’s desire to maintain their health is largely determined by their social context, so this is an important area to study:
- Availability of resources: What kinds of food does the demographic have easy access to? What is the cost of living where they live if they are in one geographical area? Is it easy to garden where they live? What sort of educational and job opportunities do they have?
- Social norms: What sort of attitude do the people around them have toward their health? Are there gyms around that are commonly used? Are bars more popular than grocery stores?
- Education: How educated is the demographic you are studying? What kind of education did they receive, and what was the emphasis?
- Transportation: Are they commonly exposed to a variety of illnesses due to a poorly maintained transportation system? Is public transportation commonly used within your demographic?
- Violence: Is the demographic you are studying often exposed to crime, violence and social disorder? This could take a toll on their mental well-being on top of their physical well-being.
- Popular culture: How exposed is the demographic to the internet and social media? How much weight do they give to what they see and hear on the internet, for better or worse?
There are a lot of factors outside of your demographic’s control to consider when studying them:
- Natural environment: If the demographic you are studying is geographic, there are a number of natural factors you should look into. Plants, weather and climate change can affect a person’s health.
- Built environment: Look into the nature of the world around them outside of the natural world. What are the conditions of the city or town they live in and the transportation they use?
- Housing: Are they living in a place where they are not in total control of how the property is maintained? Are they living with or near other people? These types of things could lead to health complications.
- Toxic exposure: Study their environment and see how likely they are to be exposed to toxic elements. This can even be their level of exposure to pollution. You should also consider their risk for other physical hazards.
- Barriers: If you are studying a demographic with a disability that limits their ability to get around easily, knowing how accessible their area is will be an indicator of their overall quality of life and health.
What individuals choose to put in their bodies greatly impacts their overall health, impacting population health. Though a lot of the factors listed above impact individual behavior, that does not change its importance. Here are individual behaviors that could seriously impact a person’s health:
- Diet: The way a person eats has major implications for their overall health. Their financial situation, as well as their access to good food, affects this. As a general rule, this is a choice they can make and a change they can make if necessary.
- Physical activity: Again, a person’s financial situation impacts their physical activity as they may not be able to afford a gym membership. Accessibility could also be a problem here. There are many ways to be physically active at home or outside, so external factors are not totally to blame.
- Substance use: The use of drugs, alcohol and cigarettes can adversely affect a person’s health. The frequency and amount of use play a big part in determining how poor a person’s health is, but as a general rule, it is best to stay away from these substances.
- Hand washing: This may seem simple, but simple habits make a big difference. This is a habit that is telling of others in a person’s life and how much they care about their overall well-being.
Our Population Health Solutions
Tangible Solutions offers quality reporting in the healthcare industry to make sure you have the population health management tools you need to serve your community well. Investing in quality reporting can build a foundation of a solid business plan and better patient care for your healthcare organization. Practically speaking, quality reporting rewards improved health care quality and reduces the overall cost of care — one of the main goals of population health management.
Our Happe-Analytics solution is a powerfully simple, full-featured service that will help your healthcare organization maximize the value of your reporting. Happe-Analytics shows how you relate to potential incentives and can provide other insights like your year-over-year improvement for key measures. If you have the resources and organizational commitment to devote the time, you can use Happe-Analytics to build and measure your population health strategy internally. Conversely, we can help supplement your strategy with external resources that can still provide your practice with meaningful rewards. Either way, Tangible Solutions is here to serve as your partner and help you get the most out of our efforts.