Renee Broadbent, AVP for Population Health IT and Strategy with UMass Memorial Healthcare is a sought-after speaker these days; not surprising considering how healthcare is changing from a fee-for-service to a pay-for performance model. And even less surprising because, for health systems, making that transition is so phenomenally complex. But Broadbent not only has a good handle on how to navigate the tricky road ahead, she’s all in to help others get there as well. That’s why she’ll be delivering a session at the upcoming HIMSS national conference entitled, “Creating a Population Health Strategy That Scales,” (session 72). In order to learn a bit more about Broadbent’s topic (and provide some information for those who won’t be making the show), healthsystemCIO.com Managing Editor Kate Gamble recently caught up with the population health expert.
People are not getting better; they’re getting sicker. How do we manage that? What can we do to improve care while also lowering costs? And so it’s really important to me that we tackle this issue; that we focus on how technology can help achieve that goal.
In order to be effective in population health management, you have to invest in the infrastructure, you have to have executive buy-in at the very highest level, and you have to have clinical buy-in in order to make it effective
The data we get from CMS and from payers, with all the claims and the various formats they come in, isn’t always clean. The effort that goes into making it meaningful and then taking it and merging it with other data sources to really create a full picture of the patient is really challenging, but it’s also critical to delivering the information you need to be effective.
I think it’s tough because a lot of ways people go into population health management market is through a track 1 ACO, which has no downside risk, but it’s also very hard to get shared savings. And so keeping that momentum is tough.
Gamble: Hi Renee, thanks so much for taking some time to speak with us. To start things off, can you tell us why population health is a passion of yours?
Broadbent: Several years ago, when I was a health system CIO, we first heard people talk about shifting toward accountable care. That caught my eye, because I’m always interested in how changes occur in healthcare. I had an opportunity to work for an organization that really focused on population health, and so I was able to learn about it.
I believe the next generation of how we deliver care must be focused on population health, with data and infrastructure being the foundation on which we can build up and support all of its different components. I also believe we have to do something because our healthcare spending is out of control. People are not getting better; they’re getting sicker. How do we manage that? What can we do to improve care while also lowering costs? And so it’s really important to me that we tackle this issue; that we focus on how technology can help achieve that goal. That’s what I’m focused on in my role.
Gamble: Right. When you talk about what it takes to build a population health management program that scales, what are the key building blocks?
Broadbent: When you build out the program, you can conceptualize it as a house. On the bottom you have data infrastructure, and on top of that you have the pillars, which are your business, your analytics, care management, financial management — all of the other pieces of the population health continuum. When you build an infrastructure, you have to have that baseline, which is aggregating data from disparate sources and then doing the analysis, care management, and admin and reporting, patient engagement, and clinical engagement. In order to build an effective program, all of those areas have to be covered. And of course, you have to build your staff. You have to have the right people in the right roles to manage population health.
Care management is a good example. How do you take the data and make it meaningful for them? You do that by providing predictive analytics so they can get ahead of some of those patients. You provide the right information to those in finance so they can manage the total medical expense.
By doing this, you start to build a framework around those pillars, and you start to populate them with people who have the right skill sets. And then you engage in the instruments that help manage population health, whether that means a Medicare Advantage program or an ACO. And if you’re an ACO, what track are you? Do you have more than one ACO? Do you engage in your commercial risk? Those things are needed to build out the program.
Gamble: There’s so many pieces that have to be in place. Another, of course, is governance. Can you talk about the office of clinical integration that was created at UMass, and how this has helped?
Broadbent: Sure. What we’ve found is that if you’re going to do population health management, you have to have executive buy-in as well as physician buy-in, at the very highest levels. One way to do that is to have an organization, within your organization, which is focused on those activities.
Take human resources, for example. They’re focused solely on things like salary, benefits, and training. This is the same principle. The Office of Clinical Integration isn’t a department shoved under another department — it sits at the organization level and is delivered across the system. I think that’s a key component.
Gamble: You mentioned buy-in, which is obviously an important component as well.
Broadbent: Absolutely, and so you build the strategies around that. In my presentation, I’m going to talk about care management and physician groups as it relates to this. Our CMO has what we calls a “pod structure” where he takes our managed care and ACO network, and breaks it up into quadrants.
At UMass, we have a large network that’s spread out all over the state. We have pods, and each has its own group with a physician lead. That’s how the CMO is able to deliver information to several different practices. We also have performance improvement facilitators who work with both the care managers and the physician practices. They go out and educate them and bring reports that say things like, ‘your a1c scores are up. Here are some workflows you can modify to improve that.’ We make sure they’re entering all the data that they’re supposed to.
And this type of model is scalable, which is what I’m going to talk about. I’ll also get into utilization management, ACO operations, performance improvement facilitators, and data access, among other things.
Gamble: It sounds like you’ll be covering all the bases. What do you hope people will gain from attending the presentation?
Broadbent: I hope they recognize that in order to be effective in population health management, you have to invest in the infrastructure, you have to have executive buy-in at the very highest level, and you have to have clinical buy-in in order to make it effective. Clinicians really need to be invested in this. Other than patients, they’re the ones most affected by it.
Another thing that makes this challenging are the regulatory changes we keep seeing, especially with a new administration. Being able to be flexible when that happens is so important. I’ll talk about that as well.
And of course, there will be a lot of data references. Data is such an important piece of this. The data we get from CMS and from payers, with all the claims and the various formats they come in, isn’t always clean. The effort that goes into making it meaningful and then taking it and merging it with other data sources to really create a full picture of the patient is really challenging, but it’s also critical to delivering out the information that you need to be effective.
Gamble: Absolutely. The last thing I want to ask goes back to what you said about why this topic is so important to you. Do you think the industry is making progress as far as the shift toward accountable care?
Broadbent: I do. I think it’s tough because a lot of ways people go into population health management market is through a track 1 ACO, which has no downside risk, but it’s also very hard to get shared savings. And so keeping that momentum is tough. I think what makes population health organizations successful is the willingness and ability to provide the technology, provide the right instruments, and progress into new, improved programs like the direct-to-employer model.
There are successful models out there that we can all learn from.
Gamble: Right. There’s so much to talk about when it comes to population health — it’s a very complex topic, but one that is so critical. Thank you again for your time, and best of luck with the presentation. It sounds like it will be great discussion.
Broadbent: I hope so. Thank you.