Partnering for Better Population Health Management
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"Both organizations believe in the value of and need for healthy communities, a lower cost of care, and greater quality of care, mostly around reducing variations in outcomes," he says. "Those are the inherent principles in our partnership, so we came together and are building the alignment and coordination necessary to meet those goals."
"We are beginning to work together more collaboratively—and with less of the past expectations of competition and trying to take market share—and win by the old standards of healthcare delivery," he adds. "We believed that this vision of working together was so compelling that we would overcome the challenges around competition."
Like Richardson, Afable believes partnering with an organization that is culturally similar to his own is critical. "What is also important is both organizations are faith-based, not-for-profit, community service organizations that have a very strong commitment to the care of the vulnerable populations within our communities."
The organization is using 2014 as a "ramping-up period" to better determine what the model will look like and how the organization will function, according to Afable.
Although there is still a lot to decide, he says the new care delivery model must be "built more around data analytics and predictive modeling. It used to be about collecting a premium and trying to hold down utilization as much as possible. That is not the model of population health, but it is a cornerstone. Now we have to do very good actuarial and predictive analysis so we can have the best ability to create a budget for caring for individuals and populations. We want to be able to determine what we would expect as far as the resources that are necessary when the best care is provided."
While population health management is a move away from the traditional fee-for-service payment structure, Afable believes provider organizations that figure out how to do it well can still make money.
"Using patient engagement and innovation, we can actually improve the cost to provide care and the outcomes of that care in such a way that we can create a margin," he says. "We believe like most people today that you have to have a model that improves outcomes, creates value, and improves financial results for providers by creating profitability. If better care and better service result in reduced financial viability in the long run, you might as well just roll it up now and be done with it."
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