Population health seems complex and difficult. Why implement a PHM platform now?
The current urgency for population health systems is due primarily to the transition from fee-for-service
to a value-based reimbursement. Although there are various iterations of value-based programs, virtually
all of them impose a new level of accountability that goes far beyond the expectations of the traditional
fee-for-service programs. Providers are being asked to offer better care while reducing the overall costs of
this care. Doing so requires measuring and reporting quality outcomes, identifying populations of patients
who share chronic conditions, identifying high-risk patients, and engaging patients in meaningful ways in
their own care. This is virtually impossible without specialized big data population health software platforms
capable of analyzing data from multiple sources such as EHRs, HIE feeds, adjudicated (paid) health
insurance claims, and patient satisfaction surveys, to name just a few.
The transition to value-based reimbursement is occurring rapidly. Health and Human Services (HHS), the
federal agency responsible for administering Medicare, is targeting to have 50% of all fee-for-service
payments linked to quality or value through alternative payment models by 2018. Commercial payers are
actively monitoring and adopting related policies. The Health Care Transformation Task Force, a leading
industry consortium of payers, providers, and purchasers, committed to having 75 percent of its respective
businesses operating under value-based payment arrangements by 2020. Effectively managing a practice
in this new environment will require a population health management platform.
This blog comes from a white paper published by EHR Integration Services and EagleDream Health.
Click here to read the white paper in its entirety, or visit our blog regularly to read all Top Ten
Essentials of Population Health.