Thanks to the new reforms that are being adopted at a national level, healthcare is currently undergoing a major transition from a payment-based service to a value-based service model. The need for change is paramount in the context of the increasing prevalence that is been accorded to population wellness programs.
Workforce Trends and Wellness
More and more organizations now are fully aware and understand that a healthy staff is always a productive staff and therefore, population/workforce wellness programs are becoming increasingly prevalent these days. Greater importance is now being given to wellness programs to enhance the efficiency of their personnel with smooth workflow.
For example, within the emerging healthcare landscape, the new core competency for leaders and managers who need to remain feasible and agile will be how to manage patients within a population health model. If we talk about value-based contracting, where incentives are directly based on healthy outcomes/results, what we will find out is that different healthcare sectors will unite to provide services in the most suitable care setting, efficiently and economically, and also maintaining the level of care that contributes to patients’ health and quality of life.
From a continuum of care point of view, effective population wellness management is dependent on community resources for patients and other individuals, access to wellness programs about self-actualization for people who want to participate in healthy lifestyles through behavioral changes. Federal programs and state policies have been enacted and these statutory mandates help healthcare and clinicians’ facilities to set up necessary information technology (IT) infrastructure to play a key role in improving health and wellness. To give you one important example: a state-based initiative like the State Innovation Model program of the Centers for Medicare and Medicaid Services (CMS).
Therefore, a cohesive communication is important to make sure that a continuity of care is provided to patients and close what could generally be called as gaps in their care (the hospital to home, specialist doctor to primary care physician, and the provision of in-home services). The population wellbeing administration is progressively seen as the answer to the developing financial pressures of a maturing demographic, also the legislative mandates to improve overall healthcare quality at reduced costs and reimbursements.
With the Affordable Care Act (ACA) that went into effect in January 2014, worksite wellness programs are set to be a part of the national public health strategy. ACA’s new rules suggest many standards for wellness programs to happen, wherein workers will be rewarded financially for meeting their health goals. By the year 2023, the annual cost of the US healthcare system is expected to be $4.2 trillion!
Transitioning To a Value-Based Population Health Management
Embracing a population health perspective has become a fundamental requisite for many of the emerging coordinated care facilities. Accountable care organizations are facilitating patient wellness through tracking and monitoring the risk level of their population and ensuring more sustainable community-focused delivery.
Taking a proactive way to deal with wellness is sound judgment – however healthcare organizations (both private and public health agencies) need to differentiate the healthy from those ones who are in need of health services or anticipated to incur significant health costs. This is a crucial element in developing a sustainable financial model that focuses on population health outcomes being delivered to individual patients in a clinical setting. In order to achieve population health, the path from illness to wellness should be in close alignment of providers and payers so that health inequities or disparities due to the involvement of social determinants will be reduced.
Health status, or for that matter population wellbeing, resides at the crossing point of three particular healthcare service mechanisms: (1) expanding the pervasiveness of evidence-based preventive health services, including individual behavioral determinants of health, (2) improving patient-centered care quality of care and patient safety and (3) driving better care coordination across the care continuum.
Additionally, it is good to note that the health status of an individual is influenced by many factors such as family history and hereditary qualities or genetics, ecological and social forces, including personal behaviors, while only a small percentage of health status owes to medical care. This supposedly environmental model of health points to the significance of upstream elements that influence health to reasonably enhance the wellbeing of any population. Therefore, improved population health outcomes are directly proportional to decreasing medical costs that will eventually allow hospitals to put their resources in prevention activities.
Populace health management continues to pick up speed as a methodology for enhancing care quality and healthy outcomes while preparing healthcare organizations to transition from a traditional fee-for-service (FFS) system to one based on value. However, there are still some valid concerns as to how long the process of transition will take and how well it can scale to fit the requirements of the many types of providers in the U.S. Still, PHM is becoming a must-have for organizations in the brave new world of healthcare.
Dossier is a (PHM) population health management solution that improves the standards by enabling the collection of operational and transactional data. for more information visit us at http://www.healthdossiersystems.com
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