Finding the right population health partners

December 20, 2016

Cross-sector partnerships to promote population health can elevate the role of a primary care physician.

Primary care physicians involved in population health initiatives will be required to think strategically about the best way they can benefit from partnerships with organizations that span multiple sectors to create a holistic approach to the health and well-being of populations of patients.

Increasingly, physicians are collaborating with other providers, hospitals, community health facilities, accountable care organizations (ACOs) and housing and education departments. These relationships are forcing discussions about the level of investments that should be committed, the agreements that need to be evaluated and the adoption of policies that need to support these efforts.

In addition to capturing and analyzing clinical data, physicians who embrace population health’s approach to care need to collect more information and pay closer attention to social determinants that have a bearing on the health of large groups of patients.

Factors impacting patient health that exist outside of a doctor’s control, such as transportation to and from appointments, the management of a nursing home or patients’ accessibility to fresh healthy foods are important considerations. This is especially true as doctors operate under a value-based system that requires them to meet clinical quality metrics to receive incentive payments.

Next: Collaborating to drive innovation

 

Given this fact, doctors need to reach out to partners to collaborate on finding innovative ways to improve patient care, said Tom Campanella, JD, associate professor of health economics and director of the Health Care MBA program at Baldwin Wallace University in Cleveland, Ohio.

To find the right partners, physicians should comb through their data looking for groups of patients that have the costliest comorbidities and find innovative ways to develop strategies that can result in improving the health of patients.

For example, by analyzing their patient-related data, physicians can identify groups of patients with Type 2 diabetes that reside in a specific geographic location. Based on this information, physicians can identify fitness clubs and nutrition programs in close proximity to where patients live and direct them to existing health-related programs. They can also partner with these organizations to offer specific programs for their diabetic population.

“Primary care physicians should see partnerships as an important tool in their quest to become better advocates for patients under the new value-based healthcare system,” Campanella said.

Next: The power of partnerships

 

The power of partnerships

As physicians figure out a way to balance the task of managing larger groups of patients with their need to make money to survive, Campanella told Medical Economics that many physicians are turning to clinically integrated networks (CIN) that help small physician practices with services such as health screenings or health counseling. Physicians are also partnering with independent physician associations (IPAs) to reduce overhead costs by providing services such as staff augmentation, technology, purchasing and other services.  

With regard to partnerships with health payers, Campanella said independent physician practices need a good lawyer who understands the terms of the agreement.

“Any contract that is drafted by a health insurance company is written to ultimately benefit that company. Independent physician practices need to look at this very critically and make sure it meets their best interests,” Campanella said.

He added that partnerships, especially with insurance companies that want primary care practices to get involved in a population health initiative, need to focus on contracts that clearly state how much they'll get paid for their services and what the financial penalties will be if they don’t meet the goals outlined.

On the business side, partnerships can present other problems. Physicians will have to assess what a population health management initiative will require. They’ll have to focus on the work it will take to monitor and manage the additional obligations that come with expanding the scope and reach of their practice and they’ll have to decide if extending their partnerships is worth the additional staff and technology it will take to monitor and manage these partnerships.

Even with these challenges, Campanella said physicians stand to gain from partnerships that spring out of a population health initiative.

“Physicians have a better chance to voice their opinions and shape the course of healthcare at the community, state and even on a national level when they partner with other healthcare stakeholders,” Campanella said. “That is something they could never do when they focused on individual patients under a fee-for-service system.”