At the center of the rings is an activated individual, one who takes charge of his or her health, understands what’s required to live a healthy life, and has the confidence to direct his or her own health improvement. The ring closest to the center calls for strategic partnerships. “These are relationships that we enter into with organizations,” Knox says. “We’re setting common aims around the health of the population, we’re partnering, we’re sharing financial risks with these partners for the outcome of that population. That’s a very close relationship.” Rice and Isham agree that fostering those associations can determine the ultimate success of this model at your facility.
Working together works
The type of hospital, its patient population, even the facility’s mission may play into with whom a hospital chooses to partner first—or at all. Consider who else has the same health goals as you do for your patients.
For example, employers likely don’t want their employees to miss work. Why not partner with businesses to educate their workers on how to stay healthy, Isham says. “Businesses are very interested in making sure that their employees … are also taking care of themselves,” he adds.
Bellin paired with several payers and has put in place on-site primary care physicians and therapists at some employers. “We’re in a performance-risk relationship around cost and quality,” Knox says. “We have an opportunity to pull a lot of levers. There’s a real opportunity to impact the population.”
Baylor took a slightly different approach to this notion of working together, partnering with the city of Dallas, where diabetes is rampant (in 2010, 14% of people living in South Dallas had diabetes, according to DHWI). The city allowed the system to renovate an already-existing recreation center to create the new institute and contributed financially to the project. Once Rice came on board, she started programs with folks in the community and at local churches. “I wanted to develop health ministries in all the churches utilizing a Baylor team,” she says. “I wanted us to be first thought of when there are health issues and engage people and impact diabetes awareness.” That idea resulted in two advisory boards: a community advisory board and a ministerial advisory board, with more than 30 total participants.
Rice recommends starting small when it comes to partnerships, even if it means following the old quality-over-quantity adage. “Today you have to partner,” she says. “No one can do it alone. Hospitals now need to change their focus and reach out to the community to further their mission.”
If nothing else, pair up with your patients, Isham suggests. Stay in touch. Understand how they want to receive communication and from whom—only by e-mail, never on the computer, over the phone, only in person, only from their personal doctor, and so on. Formulate an individual’s care plan around those preferences.
The metrics tell the story
Isham has the numbers to back up his suggestions; HealthPartners, an integrated system with hospitals and health insurance plans, incorporated population health into its care model back in the late-1990s, to great success. In the realm of treating tobacco addiction, the percentage of smokers within its patient population fell to half of what it was. In 1998, only 49% of patients were asked whether they smoked, and for six years running, that percentage has hit the mid- to high-90s. On top of that, the rate of secondhand-smoke exposure decreased from 23% in 1998 to 4% in 2010. “That’s one example of prevention success in a very large population,” Isham says. “This is not a pilot; we’re talking close to a million people here.”