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Intelligence Report: Toward Population Health



Healthcare providers appear willing to embrace the new model of population health, but the first order of business for many is to sort out the financial issues.



1 comments on "Intelligence Report: Toward Population Health"
bob sigmond (10/14/2013 at 11:19 AM)

The best and easiest way for hospitals and health systems to embrace the new model of population health is to collaborate with a Blue Cross plan or other insurer which already understands population heath. Together the two organizations can design a strategic plan for transitioning to population health and agree on an annual provider budget that carries out that strategic plan. This will work best if the hospital turns over its entire billing and collection function [and collection staff which remains at the provider site] to the collaborating third party payer organization which takes over all collections and pays the hospital/health system a single monthly check that covers all the provider organization's expenditures. This avoids the provider organization having to duplicate all the initial preparatory work that the third party payer organization has gone through in becoming expert in population health. With no more involvement with fee-for-service and collections, with no more uncompensated care, and with no more worry about the bottom line, the collaborating provider organization can concentrate on incrementally transitioning into population health, with its collaborating third party payer organization, with goals of increasing quality and access while reducing expenditures. Clearly, many details have to be worked out, including [a] the method for making adjustments whenever the expenditure budget estimates turn out to be too low, [b] how to divide up any net gains or losses at the end of the year, etc. But with trust between the two collaborating organizations, the transition to population health will be remarkably easy and effective. For more information about this approach, call me at 215-561-5730 or e-mail. Right on! Bob