Seeing Population Health at the Consumer Level

How will you master two key healthcare trends for 2017?


Despite uncertainty around future healthcare policy, providers and insurers are moving forward with two next-generation care models: risk-based contracting and population health.

Risk-based contracting is the next evolution of value-based reimbursement. It goes beyond the current positive financial incentives in place for providers to include financial penalties for poor outcomes or poor adherence to evidence-based guidelines. By shifting more risk to providers, it is designed to provide more cost-effective health outcomes.

Population health addresses groups of patients with similar health conditions or
risks — for example, diabetes, asthma, or heart disease. This approach to healthcare is intended to improve the health of large populations of consumers and patients.

The Keys to Risk-Based Population Health Success

What do you need to succeed in these two care models? To improve the health of populations, you must improve the health of individuals. That requires personalized prevention and management, which depend on:

  1. Detailed data access. This includes patient-generated data like activity and diet trackers. Social information also provides great visibility into patient health status and potential health issues. For example:

    • Employment status and income can tell you how stable a patient’s housing and food situation may be.

    • Lifestyle information reveals how active patients are and how healthy their diets are.

    • Social connectivity can determine what type of support network patients have and identify potential influencers within those networks.

    In addition, patient utilization patterns help you identify unmet needs for education, consultation, or intervention. Are patients’ utilization patterns appropriate to their risk levels and health status? What can you do to provide them with the right care at the right time?

  2. Ability to reach, understand, and influence individual patients. Of course, having data on your patients doesn’t mean you are able to influence them. To do that, you have to identify where they are on their patient journey, what types of health messages they will likely respond to, and how to engage them in their care. Remember, patients want their healthcare to be convenient and easy.

    • Preferred communication methods dictate whether your providers should reach out via social media, mobile apps, text messages, emails, phone calls, or regular mail.

    • Comfort with virtual care can mean patients will welcome an invitation to engage with a wellness chatbot or a telehealth program.

How to Leverage Consumer-Level Health Information

The more detailed information you have on your potential and current patients, the better you can care for them. The more you can engage them (especially digitally), the better their health outcomes will be.

Given limited healthcare information technology budgets to accomplish these goals, many organizations have chosen partners with expertise in the consumer experience and managing data. When selecting a partner, be sure your organization asks two questions:

  1. How — and how well — does the potential partner engage consumers?

  2. To what degree does the potential partner understand, recognize trigger points, and appropriately interact with consumers along the patient journey?

How can you succeed under risk-based contracting and population health? Success at the population level requires insight and reach at the individual level, throughout the patient journey.

Back to May 2017