What is Population Health?
Helping patients before their conditions become critical
Nationally, 5-10% of patients consume 50-60% of all health care resources. Helping these patients better manage their chronic health concerns – or better yet, preventing these chronic diseases in the first place – forms the foundation of a population health approach. This approach reaches patients before their conditions become critical.
- For example, specially-trained health coaches work with diabetic patients to teach them how to control their condition through diet, exercise, medication, and careful monitoring.
- Coaches connect patients with services that they need to comply with their treatment protocol such as transportation to doctor's appointments, financial support to purchase healthy food, or scholarships for a gym membership.
- The number of diabetic crises and hospitalizations the patient experiences should decrease as he or she takes control of the disease instead of letting the disease control their life.
Such a model improves the quality and length of the patient's life and decreases his or her cost of care while improving economic efficiencies in the community and saving tax payers millions of dollars in health care costs, disability, and lost productivity.
The Genesis Health System Response
No one tactic – whether banning the sale of large sodas, taxing so-called “sin foods” or alleviating food deserts – will solve this problem. The problem’s complexity requires a multi-faceted and multi-dimensional approach. Yet fragmentation encourages each segment – including health care – to focus only on its aspect of the problem instead of actively coordinating with other community organizations to create a community-wide solution.
In response to these calls, Genesis Health System has led the transition to preventative and patient-centered care for its most high risk patients as well as regionalization and consolidation of services to take advantage of economies of scale. For example, navigators and health coaches – specially-trained nurses and social workers – now work with chronic patients to help prevent readmissions while maintaining the highest quality of care and patient safety and improving each patient’s health outcome. Medical homes, clinical care coordination, and virtual care better engage patients in their own health care and health management, a critical first step toward Genesis’ ultimate goal: an integrated health care system with highly engaged patients in a population health model. Likewise, regionalization has allowed Genesis to take advantage of economies of scale in many of its business functions while retaining the community character of each individual hospital.
Transitioning to a Population Health Model
Very few health care systems across the country have crossed this proverbial bridge from the current fee-for-service model to a population health model. Genesis has begun its population health emphasis on the chronic conditions most prevalent in its service area and those that consume the greatest percentage of its resources: heart disease, chronic pulmonary disease, diabetes, and cancer. Success requires that the health system totally transform the way it operates; that transformation has begun. Simultaneously, health care philanthropy must support this transformation with significant changes in the way it operates including reaching beyond the health care walls and into the community where its patients live and work.