Focusing on the health of entire populations is crucially important to the advancement of both medical care and research. It serves to improve clinical treatment of specific groups by promoting better patient outcomes and lower costs for delivering services.
In the past, there has been a disconnect between technology and clinical practice. This circumstance has made it a challenge to coordinate medical services and resulted in suboptimal treatment outcomes. Alternatively, population health management helps care providers overcome these barriers by improving patient satisfaction and reducing medical costs.
Individuals who are looking to become population health experts can earn an online Master of Health Administration to prepare for the role. Through coursework and training, students learn why population health is so important and how health administration professionals implement relevant policies in their communities.
What Is Population Health?
Population health, according to the Centers for Disease Control and Prevention (CDC), is “an interdisciplinary, customizable approach that allows health departments to connect practice to policy for change to happen locally.” The study of population health focuses on the health outcomes of individuals within a certain group. Different populations often include individuals living within cities, states, or countries. However, population groups can also include people in a certain ethnic group, in the same age bracket, individuals of the same gender, professionals in an occupation, or people with a certain disability or disorder.
Population health experts seek to understand how social environments, genetics, medical care, geographic locations, behavior, and other factors have an impact on the distribution of health in a population. After specific health concerns are revealed in a studied population, communities can address those problems and improve health outcomes.
The Future of Population Health
Population health has evolved as a field over the last several years and continues to grow in significance. One of the most important aspects of population health that will impact the future of the field is understanding populations in specific health care systems. It is important for health care organizations to gain insights about their own patient populations to gather data and better serve them.
The following trends demonstrate why population health is so important and how its future will likely be shaped.
Promoting Population Health Through Value-Based Purchasing
To encourage the shift toward service quality, the Centers for Medicare and Medicaid Services (CMS) has launched four initial value-based programs: Hospital Value-Based Purchasing (HVBP), Value Modifier (VM) Program or Physician Value-Based Modifier (PVBM), the Hospital Acquired Conditions (HAC) Program, and the Hospital Readmission Reduction (HRR) Program.
These models are part of the CMS’s larger strategy to improve the quality of medical services that are delivered to program participants. A few other similar value-based payment models are the End Stage Renal Disease (ESRD) Quality Initiative Program, the Skilled Nursing Facility Value-Based Program (SNFVBP), and the Home Health Value-Based Program (HHVBP). The purpose of payment models such as these are to form a correlation between service quality and provider reimbursements. In total, these programs work to promote improved quality of services and population health.
A New Fee Schedule for Hospitals
The integration of behavioral health treatment into mainstream practice has challenged care providers for some time. As a result, the CMS has introduced a new collaborative care model. Along with the addition of four behavioral health reimbursement codes, this approach will assist providers in making great improvements in the health outcomes of U.S. patient populations. The agency has confidence that facilitating the treatment of physical and behavioral conditions in the primary care setting will greatly enhance the overall well-being of patients.
To facilitate the integration of behavioral health treatment into primary care, the CMS finalized what is known as the Physician Fee Schedule. The change reflects the agency’s emphasis on promoting better management of treatments and improved integration of primary care behavioral health services. The CMS believes this value-based reimbursement will improve care across the continuum of services, reduce financial expenses, and result in a healthier population.
he Transition to Value-Based Care
Value-based care rewards providers for working together to coordinate treatments, administer the correct services, and improve overall population health. As time goes on, insurers will continue to base their reimbursements to care providers on treatment quality rather than quantity.
The positive outcomes that have resulted due to value-based programs have caused the model to ignite one of the largest changes in the history of the health care marketplace. By linking reimbursements to service quality, insurers such as the Centers for Medicare and Medicaid Services have facilitated a massive leap forward in the performance of U.S health care providers.
This achievement is a considerable change for an industry that has received insurer reimbursements via a fee-for-service model for some seventy-five years. Soon, valued-based payment models will represent the norm, as more insurers support initiatives such as shared savings programs, integrated clinical care, and accountable care payment models.
Population Health versus Public Health
Understanding the relationship between population health and public health can further emphasize why population health is so important. While population health and public health operate in similar realms, it’s important to understand the subtle differences between the two terms.
Public Health
- Public health encompasses a much wider scope of interest than population health. Public health experts are focused on promoting health and wellness across entire populations and communities.
- Policies, health education, and research for disease prevention fall under the category of public health.
- Individual citizens might experience the influence of public health research through initiatives that are designed to improve personal habits such as hygiene and diet.
- Public health departments are responsible for preventing environmental hazards, encouraging healthy behaviors, and providing awareness of epidemics.
Population Health
- Population health deals with the health condition of a group of individuals, such as those who live in a specific city, county, or state. It also includes individuals who belong to similar racial backgrounds, occupations, or other defined populations.
- In addition to being concerned with health conditions, the discipline involves a focus on the treatment outcomes of individuals within specific groups.
- Population health researchers evaluate how differences in income, education, and medical access affect the well-being of a specific group of individuals.
- Local care providers and health agencies establish initiatives to treat threats that may affect the entire U.S. population. Many times, such efforts are mandated by legislators to protect public health.
When communicating with peers, it’s important that current and future health care administrators use the terms “population health” and “public health” in the proper context. Additionally, medical professionals must understand how the outcomes of individual treatments affect population health. Armed with this knowledge, future care providers can contribute to the well-being of the country’s populations one patient at a time.
Pursue a Master of Health Administration Degree
At Regis College, we provides various pathways for you to pursue your goals in health care administration. As a dedicated leader of health administration education, we welcome ambition-driven, self-motivated professionals like you from all health care settings.
Gain special insight into areas such as management, communications, health informatics, and health policy through our Master of Health Administration online as you learn why population health is so important to the future of health care.
Recommended Readings
Improving Patient Care through Clinical Integration
4 Things to Know About Telehealth
Sources:
Advanced Data Systems Corporation, “The Difference Between Population Health & Public Health”
Centers for Medicare and Medicaid Services
Institute for Health Care Improvement, “Population Health: Learning from the Past to Shape the Future”