The world of population health management (PHM) is ever changing and evolving. It makes me think of the game of basketball. As a child learns to play the game of basketball, shooting stands out as a very important part of the game. Shooting leads to scoring, and scoring is what is displayed on the scoreboard. Without shooting, basketball would be a boring sport to watch indeed. Naturally, many players focus on developing their skill in shooting so that they can score and see their points on the scoreboard.
The PHM market has been a lot like the player learning to play basketball. The thing we have been focused on most is what brings the quickest and easiest returns, or in other words, puts points on the board. The thing that puts points on the board most easily in PHM is taking care of high-risk and high-cost patients. When a high-risk or high-cost patient is well taken care of, the returns for a healthcare provider stack up very quickly. Points are put up on the board.
But that’s not enough. We need to move past just putting points on the board. We need to focus on more than just shooting. Shooting is an essential part of the game of basketball, and being good at shooting is a great skill, but looking into the future, there are additional skills and abilities that are going to be needed to progress in the game. There is dribbling, passing, defense, set plays, and picks, not to mention referees, a time clock, and the opposing team trying to steal the ball away from you or block you. There are so many aspects to the game of basketball that focusing on just one will never get you to the NBA.
The underlying idea of population health is that we need to take care of the entire population, not just the high-risk patients who bring the greatest benefit to the organization. Taking care of the entire population requires interactions even with those patients who may not cost the system anything right now. It means practicing other aspects of population health — besides shooting — that are fundamental to the game.
Moving to the next league is going to happen, but whether providers are prepared for that level will depend on the development of skills outside of shooting, or just chasing the low-hanging fruit. In the rest of this series, we will explore the fundamentals of PHM and the journey to becoming a winning team.
Bradley Hunter is a Research Director at KLAS Research, specializing in population health management and health information exchange. For more information about KLAS, click here. To follow KLAS on Twitter, click here.