Behind the Costumed Language of Population Health

Just like an eager group of kids in search of Halloween candy, the jargon of healthcare can wear costumes, too. Whereas kids’ costumes are often spooky or silly, healthcare’s can be downright confusing. They obscure rather than clarify and it’s important to demystify some of these perpetually perplexing terms. As a wise man once said, “The beginning of wisdom is to call things by their proper names.”

Population Health

Some mistakenly call “pop health” a buzzword, one that sounds vague and optimistic. However, data suggests this allegedly inexact term has incredible, measurable benefits for patients, providers, and the healthcare system as a whole.

• More than 40 percent of Medicare Advantage plans will offer population health benefits in 2019.
• Maryland officials noted a correlation between population health initiatives and a reduction of 18,652 inpatient stays, which led to savings that “far outweighed the initiative’s cost.”
• Indianapolis-based Eskenazi Health utilized population health “wraparound” strategies to save $1.4 million, reduce expected hospitalizations by 7 percent, and lower emergency department visits by 5 percent over a 10-year period.

I explain to those critics that pop health is very real, if somewhat all-encompassing. (We’ve dedicated entire blog posts to the topic.) To put it concisely, population health involves segmenting patients to distinguish, decipher, and implement treatment plans that improve patient health outcomes.
In a sense, the phrase should really be populations health. After all, a single patient will inevitably belong to multiple populations: Type-1 diabetes, elderly, geographic location, financial situation, past medication adherence, etc. This segmentation — and subsequent treatment strategies — can be easily achieved with a powerful electronic health record (EHR). With a user-friendly, comprehensive EHR, you can quickly and easily divide your populations to identify methods to better serve them.

Patient-Centered Medical Home (PCMH)

The word “home” here is misleading. A PCMH is not a facility as much as a homebase for providers to coordinate and deliver comprehensive care. This delivery model reduces duplication, aligns with payers, and manages chronic conditions to emphasize patients’ role in their treatment plan. This long-term, team-based approach fosters facilitation through registries, IT solutions, EHRs, health information exchanges, and referrals. All of this is then made accessible and digestible for the patients to empower them as healthcare consumers. Furthermore, the PCMH model prioritizes quality and safety metrics, evidence-based medicine, and clinical decision-support tools to advise all parties on how to best assist patients.

Public Health

Public health and population health sound similar, and for that reason, are often used interchangeably. The main differentiator is the level of specificity:

• Population health refers to a specific group of patients and their medical outcomes.
• Public health, on the other hand, concerns the population at large, which includes all of those separate populations.

According to the American Public Health Association, “Public health works to track disease outbreaks, prevent injuries and shed light on why some of us are more likely to suffer from poor health than others. The many facets of public health include speaking out for laws that promote smoke-free indoor air and seatbelts, spreading the word about ways to stay healthy and giving science-based solutions to problems.”
Another key factor, as illustrated by these examples, is the level at which the change takes place. Public health initiatives usually occur at a governmental, national level while population health is generally between patients, providers, and payers.

Triple vs. Quadruple Aim

The Institute for Healthcare Improvement’s “triple aim” is a threefold method to repair healthcare by bolstering the patient experience. This method’s framework involves “improving the health of populations, enhancing the experience of care for individuals, and reducing the per capita cost of healthcare.”
A new approach adds a fourth objective: increase provider satisfaction.
Whereas the original three are patient-centered, this add-on is provider-focused. Given the current rates of burnout and the doctor-patient relationship’s impact on health outcomes, empowering providers to offer best-in-class care benefits patients indirectly. There is a tremendous amount of crossover, too. An intuitive EHR not only saves the provider time and stress, but also decreases the chance of making an error that could cost patients physically or financially. Virtual scribes are another tool to reduce administrative burden, which is the most frequent cause of doctors’ dissatisfaction. As Bridget Duffy, MD, an expert on the topic, says, “By reducing administrative burdens and creating an environment that is optimized for healing, we can leave more space for connection and joy, driving improvement in all other areas.”
I hope these definitions help debunk and demystify some of population health’s more confusing terms. Population health has the potential to advance the transition to value-based care, increase wellness management (as opposed to “sick care”), and drive revenue for providers.
Sound too good to be true? Take a minute to discover how physician-led ACOs generate money for providers while helping patients and advancing population health!