Population Health Pays Off

This article appears in the December 2011 issue of HealthLeaders magazine.

When Dallas-based Baylor Health Care System tapped Donna Rice, MBA, RN, CDE, FAADE, to become president of its new Diabetes Health and Wellness Institute in 2008, the idea was to take a different approach to treating the chronic condition, led by someone with years of experience in the field. Rice, former president of the American Association of Diabetes Educators, took the ball and ran.

Baylor, a system that includes 26 acute care hospitals, let Rice, despite her moving away from the system’s more conventional methods. “I didn’t want that traditional care model,” Rice says. “I didn’t want people coming in to see the physician and going home.” Rather, she steered the institute to focus on an integrated behavior-driven, patient-centric model with other healthcare providers, tailored to specific populations within the larger diabetes population, one that looks at diabetes as a part of each individual’s care rather than the only factor. In a phrase, population healthcare.

In just 12 months, this new Baylor arm has seen 1,700 patients and has had thousands of visits. It has already helped lower A1Cs, and in 2010, total diabetes-related emergency room visits dropped from 1.29 to 0.77 per patient. Even green space near the facility sees more action with 30 or so people participating in daily morning walks. “If you have other issues”—trying to pay for your family’s food, for example—“diabetes care is going to take a backseat to other social and economic issues that people face. South Dallas is a high-risk, low-income area with a young female population. Oftentimes, diabetes is not on their radar,” Rice says. “We knew that our focus had to be different.”

A similar population healthcare mentality seems to be seeping into more and more hospitals, leading them to edit their playbooks. Institutions large and small, some with thousands of patients, others with millions, are succeeding at using this strategy to treat many patient-plaguing ailments like diabetes, congestive heart failure, and tobacco addiction. But it’s not a simple shift or one that comes easy to many who sit in the C-suite—perhaps because it requires allowing partnerships and risk sharing or because it takes significant up-front investment and patience to see results.