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Analysis

Top Hospital Care Delivery Redesigns and Triple Aim Performance

By Jonathan Bees  
   September 13, 2018

In a recent HealthLeaders research report, respondents achieved a fairly high level of strength where they have redesigned care delivery with the intent of supporting population health management.

Care redesign is an essential component of population health development, and nearly all providers are involved in this activity to some degree or another, according to a 2018 HealthLeaders Media Population Health Survey.

Survey results indicate that the top three delivery of care areas that have been redesigned with the intent of supporting population health management are care management with risk-based patient panels (59%), clinical programs organized by disease state (57%), and telemedicine (51%).

Compared with last year’s survey, the three areas showing the greatest increases in response are telemedicine (51%, up 11 percentage points); care goals, incentives aligned across continuum (44%, up 10 percentage points); and systems to identify gaps in care (48%, up eight percentage points).

The good news is that respondents report having achieved a fairly high level of strength in those areas where they have redesigned the delivery of care with the intent of supporting population health management.

For example, combining responses for very strong and somewhat strong yields the following ranking: clinical programs organized by disease state (64%), care management with risk-based patient panels (62%), and team-based care in patient-centered medical home (55%).

On the other hand, remote monitoring (60%), telemedicine (54%), and care registries organized by disease state (50%) receive the highest responses for combined very weak and somewhat weak responses, an indication that their role in population health is still evolving.

Triple aim goals

Some aspects of developing population health competencies are further along than others, and industry progress in this area is not necessarily linear or uniform in its progression.

As an example, respondents indicate that their organization’s level of strength for population health’s triple aim goals is stronger for improving patient experience of care (79% very strong or somewhat strong combined) than improving the health of populations (63% very strong or somewhat strong combined), and reducing the per capita cost of care (55% very strong or somewhat strong combined).

It is not surprising that reducing the cost of care turns up as the weakest of the triple aim goals—it doesn’t matter whether reducing the cost of care is associated with population health activities or any other healthcare initiative, this particular aspect of healthcare is especially vexing for providers.

And it is likewise not surprising that improving patient experience of care is the strongest aim, given the emphasis that providers and the Centers for Medicare & Medicaid Services currently give patient experience.

“If it were easy, if it was all about waste, we’d have had this thing fixed a long time ago,” says Frank E. Belsito, DO, MMM, chief physician executive, and chief population health officer at Metro Health – University of Michigan Health.

Based in Wyoming, Michigan, and affiliated with University of Michigan Health, Metro Health is an integrated health system that features a 208-bed acute care hospital and numerous outpatient locations throughout western Michigan.

“The problem is, you’re dealing with individuals. Everybody in a global sense can identify what we need to do, but as patients, we all want X, Y, and Z, and we want it now,” he says.

 

 

Jonathan Bees is the senior research analyst at HealthLeaders Media.

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