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The Real Trend in Population Health

Tracey Moorhead, September 23, 2009

Last week, the population health management industry paused to consider the implications of a bankruptcy filing by LifeMasters Supported SelfCare, a long-time leader in disease management and population health management. Health Plan Insider readers were asked to consider whether the event represented an isolated case or a barometer for an entire industry. But the question reflects an out-of-date perspective on the services that innovative companies in the industry provide and left a false impression on casual observers.

Certainly, those who follow the industry closely recognize that events leading to LifeMasters' Chapter 11 filing were both unfortunate for, and unique to, that organization. But one unique and unfortunate occurrence does not a trend make.

Only those not directly involved in the development, implementation or evaluation of population health management programs would fail to recognize the industry's evolution to one that bases services on the needs and resources of the populations and providers served. Close observers of the industry recognize its significant transformation through adoption of multiple intervention modalities in addition and complementary to the traditional call center model.

Today, leading industry organizations are deploying proven health promotion, prevention and chronic care management services spanning an entire populations' continuum of health—the well, at-risk, and chronically ill.  Organizations throughout the industry have developed more collaborative and innovative models of care delivery to fully integrate services with practicing physicians to support individuals in adherence to physician-led care plans.

Further, significant new opportunities for the population health management industry are contemplated by ongoing federal activities to enact healthcare reform legislation. Congressional leaders and the Obama administration have strongly emphasized the importance of prevention and wellness activities, sought to improve access to care coordination and coaching support programs to targeted beneficiaries, and promoted the widespread adoption of health information technologies to collect, share, and analyze health-related data.

These proposals and others, including a proposal to establish an "Innovations Center" within the Centers for Medicare and Medicaid Services to test a variety of care models and interventions in Medicare fee-for-service, were included in a proposal put forward last week by Sen. Max Baucus, D-MT, chair of the powerful Finance Committee.

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