For those in healthcare. By those in healthcare.

Is population health management universal?

Organizations are applying population health management (PHM) protocols to ever-increasing shares of their patients, hoping to extend the PHM care delivery model and infrastructure across a wider array of value-based programs. As providers look to transfer the industry’s best practices into their specific environments, they need some degree of comparability and commonality among PHM initiatives so they can assess them for applicability to their context. What they’re finding, though, is that tactics used with one sub-population (e.g., Medicaid) may not be entirely transferable to all populations (e.g., disease-centric or ACO programs). The characteristics of the managed population, the factors involved in varying payment models, and other differences among PHM deployments make it difficult to evaluate and extend PHM best practices and models.

In the real world, healthcare is not a one-size-fits-all model, as programs, population characteristics, objectives, incentives, and more can vary widely. Success is influenced not just by the specifics of the program itself, but the nature of the populations that are being managed – so healthcare providers tailor their approach according to the needs of their population and how their results are measured and incentivized. If a program takes on more downside risk, for example, or rewards certain activities such as outreach, healthcare providers will organize themselves accordingly. Such diversity means that success in one program may not easily translate to success in a different program.

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DSRIP, GSI Health, Medicaid Health Homes, Population Health, population health management


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