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1
Into the Looking Glass: New Perspectives on the Complexities of Population Health
Session PH4, March 5, 2018
Joe Damore, FACHE, Vice President of Population Health Management, Premier, Inc.
Jay Srini, FHIMSS, MS, MSBA, SCS Ventures, University of Pittsburgh
William M. Russell, MD, CMIO, Medical Specialists of the Palm Beaches
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Joe Damore, FACHE
Jay Srini, FHIMSS, MS, MSBA
William M. Russell, MD
Have no real or apparent conflicts of interest to report.
Conflict of Interest (30pt Verdana)
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Agenda• Setting the Stage
• Panelist Introductions
• Q&A
4
Learning Objectives• Develop a broad understanding of the multifaceted components
influencing population health management
• Comprehend the importance of integrating cultural competence and social factors into population health management strategies
• Explore the complexities of establishing an organizational population health strategy and discuss the role frameworks, such as the HIMSS population health management model, have in developing that strategy
• Formulate “next steps” as takeaways from the discussion
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Setting the Stage
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Jay Srini
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A tale of 2 cities in Pittsburgh- similar to most cities in US
http://beltmag.com/so-many-houses-so-
little-money-how-to-manage-the-
abandoned-properties/
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November 2015 | Issue Brief Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity
Harry J. Heiman and Samantha Artiga
Conditions people are born grow live work and age- WHO Definition
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Outside the Traditional Healthcare Sectors WHAMGlobal Pittsburgh, the first chapter launched, held
their Big Idea Challenge on June 26 2017for the next big
idea that would activate the community to improve
women's health around any of the of the following topics:
- Mental Health or Substance Misuse
- Patient & Consumer Activation (safety, quality, access,
equity)
- Social & Environmental Determinants of Health
- Violence
- Women's Health Issues
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CNN Top Heroes 2015
Dr. Jim Withers, founder and medical director, Pittsburgh Mercy’s Operation Safety Net and outreach program specialists Nic
Wilder and Christopher Roach on street rounds. Courtesy of Pittsburgh Mercy Health System.
https://www.nextpittsburgh.com/business-tech-news/pittsburghs-dr-jim-withers-cnn-top-ten-hero/
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Solutions for Patient Engagement – need to focus on SDOH as well
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References
• https://hpi.georgetown.edu/agingsociety/pubhtml/cultural/cultural.html
• https://www.kff.org/disparities-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/
• https://us10.campaign-archive.com/?e=b83b5d0cb0&u=8a4bf5d1617f86a90e5a909f0&id=104ede93d8
• https://www.psychiatry.org/newsroom/news-releases/america-s-frontline-physicians-call-on-government-to-act-on-the-public-health-epidemic-of-gun-violence
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3863696/
• Brach, C. & Fraser, I. 2000. Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Medical Care Research and Review, 57 (Supplement 1), 181-217.
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Joe Damore
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Agenda
• Joe Damore, FACHE-VP Population Health Management, Premier Inc.
• Integrating Value Based Care/Payment
• Market Segments/Strategies
• It’s a Journey
• Thank you (Joe_Damore@Premierinc.com)
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Integrating VBC redesign & New VBP Arrangements
VB Care Redesign
• Patient Centered Medical Home
• Patient Engagement
• Clinical Integration
• Care Management
• Post-Acute Care
• Electronic Health Record
• PHIT/Data analytics
VB Payment Arrangements
• Care Transformation Costs
• Care Management Payment
• Shared Savings
• Episodes of Care Payment
• Global Payment
Care redesign must not outpace
changes in payment
Value-Based
Transformation
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Value-based payment market segments / strategies
• Employee Health Plan
• Uninsured
• Medicare ACO
• Medicare Advantage
• Medicaid
• Commercial Health Plans
• Direct to Employer
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1. Preparatory
2. Transformati
onal/
Build Core Capabilities
3. Implementa
tion
VBP Arrangeme
nts
4. Expansi
on
and
PI
Four Stages in the Journey to Population Health Management
• Education
• Assessment
• Gap
analysis
• Operational
plan
• Primary care
• Patient engage
• Advanced
Primary Care
• Clinical
integration
• Care
management
• CI Network
development
• Health
informatics
• Defined
population
payer plan
• Pilot VBP
arrangement
• Employee
health plan
• Commercial
arrangement
• Medicare
ACO
• Medicare
Advantage
• Medicaid
• Employer
contracting
• Uninsured
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Bill Russell, MD
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Learning from Black Death
• Plague bacillus spread by rodents and the fleas that live on them
• Caused by bite
– Killed 30 million Europeans in the 14th
century, 12 M Chinese in the 19th c.
– No person to person cases in USA since 1924
• Intervention:
– Sanitation
– Eradication
– Quarantine (40 days of isolation)
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The Roots of Pop Health• William Petty, Md
– Matched manpower assignments to the aggegated incidence of recorded illnesses in London (1660)
• Dr. Redi
– “People’s health is assured more by an orderly life and a wise behavior at the table than by those boxes with long, beautiful and mysterious names in the shops of apothecaries” (1670)
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Information Flows to the Care Model
• Segmenting populations allows providers to apply or ignore evidence based interventions to people who might be included in multiple denominator.
• Connections to the contextual and whole person data, especially the “non medical” data, allows the provider to solve for the “N of 1”
• Each data set and data flow must add value to the sponsor to exist
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Questions
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