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Into the Looking Glass: New Perspectives on the Complexities of Population Health

Session PH4, March 5, 2018

Joe Damore, FACHE, Vice President of Population Health Management, Premier, Inc.

Jay Srini, FHIMSS, MS, MSBA, SCS Ventures, University of Pittsburgh

William M. Russell, MD, CMIO, Medical Specialists of the Palm Beaches

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Joe Damore, FACHE

Jay Srini, FHIMSS, MS, MSBA

William M. Russell, MD

Have no real or apparent conflicts of interest to report.

Conflict of Interest (30pt Verdana)

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Agenda• Setting the Stage

• Panelist Introductions

• Q&A

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Learning Objectives• Develop a broad understanding of the multifaceted components

influencing population health management

• Comprehend the importance of integrating cultural competence and social factors into population health management strategies

• Explore the complexities of establishing an organizational population health strategy and discuss the role frameworks, such as the HIMSS population health management model, have in developing that strategy

• Formulate “next steps” as takeaways from the discussion

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Setting the Stage

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Jay Srini

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A tale of 2 cities in Pittsburgh- similar to most cities in US

http://beltmag.com/so-many-houses-so-

little-money-how-to-manage-the-

abandoned-properties/

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November 2015 | Issue Brief Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity

Harry J. Heiman and Samantha Artiga

Conditions people are born grow live work and age- WHO Definition

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Outside the Traditional Healthcare Sectors WHAMGlobal Pittsburgh, the first chapter launched, held

their Big Idea Challenge on June 26 2017for the next big

idea that would activate the community to improve

women's health around any of the of the following topics:

- Mental Health or Substance Misuse

- Patient & Consumer Activation (safety, quality, access,

equity)

- Social & Environmental Determinants of Health

- Violence

- Women's Health Issues

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CNN Top Heroes 2015

Dr. Jim Withers, founder and medical director, Pittsburgh Mercy’s Operation Safety Net and outreach program specialists Nic

Wilder and Christopher Roach on street rounds. Courtesy of Pittsburgh Mercy Health System.

https://www.nextpittsburgh.com/business-tech-news/pittsburghs-dr-jim-withers-cnn-top-ten-hero/

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Solutions for Patient Engagement – need to focus on SDOH as well

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References

• https://hpi.georgetown.edu/agingsociety/pubhtml/cultural/cultural.html

• https://www.kff.org/disparities-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/

• https://us10.campaign-archive.com/?e=b83b5d0cb0&u=8a4bf5d1617f86a90e5a909f0&id=104ede93d8

• https://www.psychiatry.org/newsroom/news-releases/america-s-frontline-physicians-call-on-government-to-act-on-the-public-health-epidemic-of-gun-violence

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3863696/

• Brach, C. & Fraser, I. 2000. Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Medical Care Research and Review, 57 (Supplement 1), 181-217.

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Joe Damore

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Agenda

• Joe Damore, FACHE-VP Population Health Management, Premier Inc.

• Integrating Value Based Care/Payment

• Market Segments/Strategies

• It’s a Journey

• Thank you (Joe_Damore@Premierinc.com)

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Integrating VBC redesign & New VBP Arrangements

VB Care Redesign

• Patient Centered Medical Home

• Patient Engagement

• Clinical Integration

• Care Management

• Post-Acute Care

• Electronic Health Record

• PHIT/Data analytics

VB Payment Arrangements

• Care Transformation Costs

• Care Management Payment

• Shared Savings

• Episodes of Care Payment

• Global Payment

Care redesign must not outpace

changes in payment

Value-Based

Transformation

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Value-based payment market segments / strategies

• Employee Health Plan

• Uninsured

• Medicare ACO

• Medicare Advantage

• Medicaid

• Commercial Health Plans

• Direct to Employer

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1. Preparatory

2. Transformati

onal/

Build Core Capabilities

3. Implementa

tion

VBP Arrangeme

nts

4. Expansi

on

and

PI

Four Stages in the Journey to Population Health Management

• Education

• Assessment

• Gap

analysis

• Operational

plan

• Primary care

• Patient engage

• Advanced

Primary Care

• Clinical

integration

• Care

management

• CI Network

development

• Health

informatics

• Defined

population

payer plan

• Pilot VBP

arrangement

• Employee

health plan

• Commercial

arrangement

• Medicare

ACO

• Medicare

Advantage

• Medicaid

• Employer

contracting

• Uninsured

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Bill Russell, MD

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Learning from Black Death

• Plague bacillus spread by rodents and the fleas that live on them

• Caused by bite

– Killed 30 million Europeans in the 14th

century, 12 M Chinese in the 19th c.

– No person to person cases in USA since 1924

• Intervention:

– Sanitation

– Eradication

– Quarantine (40 days of isolation)

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The Roots of Pop Health• William Petty, Md

– Matched manpower assignments to the aggegated incidence of recorded illnesses in London (1660)

• Dr. Redi

– “People’s health is assured more by an orderly life and a wise behavior at the table than by those boxes with long, beautiful and mysterious names in the shops of apothecaries” (1670)

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Information Flows to the Care Model

• Segmenting populations allows providers to apply or ignore evidence based interventions to people who might be included in multiple denominator.

• Connections to the contextual and whole person data, especially the “non medical” data, allows the provider to solve for the “N of 1”

• Each data set and data flow must add value to the sponsor to exist

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Questions