Just More Acronyms or a New Mindset – Population Health

MACRA, MIPS, ACO, MSSP, PCMH, PQRS, MU – does this alphabet soup mean anything to you? How many of these programs does your organization participate in? Are you succeeding?

The healthcare industry is not just adding few more acronyms to keep us on our toes, the industry is shifting focus. The way in which we provide, receive, access, and pay for health care is turning upside-down due to this polarizing force we call population health.

Population health is a data driven approach to preventive care with the goal of producing positive health outcomes for patients. One can be easily fooled with the use of “population”. The true key is more focus on the individual patient to drive an overall healthier population.

Here are three ways to begin acquiring the population health mindset:

1. Focus on preventive services: Starting in January 2011, CMS began covering new preventive services that provide both a strong fee for service reimbursement and an opportunity to focus on the individual patient. These services include the annual wellness visit, transition of care management, and chronic care management.[1] The comprehensive nature of these visits­- the required touch points with patients at crucial times during their care and emphasis on care plan creation and management- pushes providers to practice preventive instead of reactionary medicine.

2. Utilize accessible technology: We are all too familiar with the painstaking process of implementing an EMR and practice management system. The utility of these products is both in the efficiency with which you can put structured information in and the comprehensiveness of the information that you can pull out. The information in the EMR is only as powerful as the quality of the data you put in to it and the ability of the system to generate meaningful reports. Review of the process of putting data in is essential to capturing complete medical record documentation which meets both billing and quality measure requirements. Regular review of reports can lend valuable operational and clinical insight, especially when used to identify gaps in patient care.

3. Align incentives: With increased focus on the individual patient and preventive services, it is important to align provider and staff incentives with an emphasis on quality. According to an MGMA poll, only 26.54% of providers have quality performance metrics tied to their compensation plan. [2] The population health mindset necessitates that the provider be aware of quality measures and meeting the patient’s preventive care needs. Staff should also be well trained and have a strong understanding of the importance of these preventive services so they can aide in scheduling and supporting the patient’s care team.

If you’re interested in learning more about shifting your organization’s mindset or would like guidance about any population health program that you participate in, contact us for more information.

[1]CMS “Preventive Services” https://www.cms.gov/Medicare/Prevention/PrevntionGenInfo/

[2] MGMA Connection. September 2016. “MGMA Stat Polling Initiative”