Increasing long-term population health is essential for individuals, communities, and healthcare systems. However, despite impressive efforts across organizations, population health maturity within organizations remains low.
The truth is that the task of transforming healthcare is complex, and there is no clear path forward. The entire healthcare ecosystem must band together to overcome significant challenges impeding access and cost of care. The question is: Where to begin?
To help you get started, we rounded up top trends to guide your Population Health strategy in 2022 and beyond.
Fixing the Payer-Provider Model
Improving population health and controlling costs is not part of the design of the current payer financial model in U.S. healthcare. Instead, the focus is on treating illness, and, as such, providers receive payment for transactional care. But influencing population health and controlling costs takes more than appointments, tests, and procedures. Here are some of the innovations we're seeing in the payer-provider model.
Top Trend: Lower Cost Care Settings
During the COVID-19 pandemic, we saw a sharp spike in telehealth and other remote access solutions. This trend will continue, and many providers are expanding virtual appointments across their care lines. However, questions remain about access, pricing, and reimbursement for these alternative care settings.
It's also possible that we may see expanded home-based care options in the upcoming year. Delivering more remote services may allow organizations to reduce the number of facilities, significantly decreasing overhead costs.
Top Trend: Evaluating Alternative Economic Models
Relationships between payers and providers are becoming increasingly collaborative. Evidence of this is the movement from contractual agreements with accountable care organizations to different models, including joint venture and full vertical integration mergers.
Using Technology to Drive Better Outcomes
Lack of data and understanding has long been a stumbling block in achieving value-based care. But the accelerated adoption of technology can secure better outcomes for payers, providers, and TPAs.
Top Trend: Facilitating and Supplementing the Patient Journey
Health systems are looking to technology to support new avenues for patient interactions. Beyond telehealth, other efforts include mobile apps that guide the patient journey in ways beyond just accessing health records. For example, with mental health patients, applications are being designed to provide auxiliary information.
Top Trend: Reducing Administrative Work for Doctors
Doctors spend more than half their time on paperwork and EHR-related tasks. Besides being a productivity drain, this glut of administrative tasks is detrimental to the cost of healthcare. And, since doctors are filling out forms instead of seeing patients, this can create access problems. To change this, organizations are leveraging technology such as electronic self-service solutions and EHR workflow integrations.
Top Trend: Creating a 360° View of Patients
The goal is a comprehensive understanding of a patient — no matter how, where, and when they receive treatment. The good news is that we're getting closer. Integrated data and workflow enable the real-time exchange of information between payers, providers, and patients. In some cases, data sharing happens between health plans to allow data tracking as people move between insurance and health systems.
Seeking New Partnerships
Now, more than ever, partnerships are pivotal to organizational health — both with other stakeholder groups and with partners who can enable better results.
Top Trend: Collaboration Across Stakeholder Groups
In the last year, some of the most impressive results stemmed from the combined innovation of payers and providers. Alignment across groups can help with cost containment — for example, if payers and providers are aligned, it can influence pharmaceutical pricing and billing structures.
Incubation offices are another notable trend likely to improve member experience and improve cost of care. Instead of rolling out ideas across the entire patient group, payers and providers work together to create and test customer value hypotheses before widespread implementation.
Top Trend: Outcomes-based Technology Partnerships
While it's clear that technology is key to advancing population health initiatives, technology hasn't always been a core competency of payers, providers, and TPAs. Companies embracing these emerging trends use a company like Concord to provide flexible staffing, progressive delivery, and elastic services to support your efforts every step of the way.