Tackling Population Health with Community and Patient Partnerships
While Convergence in Healthcare and other movements are transforming healthcare by bringing new treatments and technologies to the fore, it’s also important to focus on patient outcomes and ask why some populations fare better than others. Population health is becoming a focus in clinics and hospitals across the nation, with many researchers delving into the important issues around healthcare disparities.
Population health was addressed directly at the recent U.S. News Healthcare of Tomorrow Conference in Washington, D.C. in November 2018. During the conference, panelists outlined the clinical implications of population health, including the creation of custom-tailored services for patients based on their particular risk profiles, as well as partnerships with community organizations to address financial issues and develop sustainable healthcare solutions.
Partnering with Local Organizations to Drive Success
In this context, “local organizations” may mean many different things, from nonprofits to school districts. For example, Aurora Public Schools and Children’s Hospital Colorado formed a partnership that demonstrated a link between oral health and school absenteeism among students. Working with the school district made it possible for the hospital to provide a population-level solution at the school, without having to contend with federal data-sharing rules to identify which individual students had oral health issues causing them to miss school.
By sending dental hygienists directly into the school, the hospital helped students to be more present and engaged in their classes. With the partnership established, Children’s Hospital now also has a clear link to the school and can provide other population-level interventions.
While the success of this partnership is exciting, there are challenges in developing and implementing such programs. One of the most immediate issues is the cost. Keeping costs contained can require multiple layers of partners. In the example above, the hospital incurred much of the cost, and the risk, of the program.
However, if other organizations become involved, the financial risk of a pilot program can be spread across all stakeholders, ensuring the burden does not fall on one group. When providers do not obtain buy-in from other organizations, they’re limited in what they can do simply because of the risk involved. Bringing in multiple partners means funding from several different sources, including federal and state governments, can be used to build something unique and focus on the needs of a particular population.
The other issue is evaluation. Healthcare providers not only need to remain realistic about the population- and community-level factors they can address, but they also must ensure their initiatives have a positive impact. In other words, they must use assessments and evaluations to reveal the patient outcomes and results of their investment in a program. For an intervention to continue, it needs to hold value for the patient and from a financial point of view. If a program is cost-effective, it becomes much easier to obtain buy-in from other organizations, especially when there are clear benefits for a particular set of patients.
Developing Rapport and Trust with Patient Populations
Of course, these sorts of population-level interventions do not come out of the blue. Healthcare providers need to develop close relationships with their patients to understand their needs and wants. Many of the panelists at the Healthcare of Tomorrow conference pointed out that healthcare is a business, and patients are customers. In addition, the paternalistic model of patients blindly following the advice of their doctors largely died out decades ago, but practices have still not caught up to the expectations of patients.
A prime example comes directly from the millennial generation. Younger adults do not subscribe to the family-doctor model to the same extent as older generations; they also tend to prefer digital services whenever possible, as well as more personalized options. While not having a primary care provider may put these younger adults at risk if they aren’t receiving regular health screenings, it may not be effective to force the old model on them. Rather, this population may respond more favorably to providers who offer technology-driven solutions that remind them how and when to receive prevention care. A similar shift in thinking is necessary to provide customized services to populations and is also the first step in establishing trust.
However, trust demands more than just a shift in approach. At the conference, Chanin Wendling, an associate VP for Geisinger Health System, described a big change the company adopted in 2015 — it began to offer refunds to patients who had received poor service. These refunds included all forms of patient individual financial responsibility, including deductibles, coinsurance and copays, so no one had to pay for care they deemed not worth the money. While the healthcare industry was shocked by this, the move is intended to establish trust with patients and show them the company is less interested in money and more focused on quality care. The company has continued to innovate by simplifying its financial statements and the way in which it delivers test results to patients.
