Health Plans Foster Population Health with Care Coordination, Case Management

As population health management (PHM) finds its footing in value-based healthcare, PHM program focus, support tools and key players continue to shift, according to 129 respondents who participated in the latest Population Health Management Survey conducted in June 2014 by the Healthcare Intelligence Network. Areas covered by health plans differed slightly from hospital/health systems: 100 percent of health plans focused on care coordination/advocacy, versus 92 percent of hospital/health systems, as well as case management (100 percent versus 77 percent for hospital/health systems). A sampling of this sector’s results follow.

In terms of target populations, health plans targeted commercial populations more frequently than hospital/health systems (86 percent versus 62 percent for hospital/health systems), as well as Medicare beneficiaries (86 percent versus 77 percent for hospital/health systems) and healthy people (14 percent versus 0 percent for hospital/health systems).

The makeup of health plans’ PHM team was also markedly different; health plans were twice as likely to include health coaches (86 percent versus 46 percent for hospital/health systems) and social workers (71 percent versus 48 percent for hospital/health systems), and slightly more likely to include case managers (100 percent versus 92 percent for hospital/health systems) and registered dieticians (57 percent versus 46 percent for hospital/health systems).

Tools used to determine PHM intervention also varied; health plans were four times as likely to use biometric screening (57 percent versus 15 percent for hospital/health systems) and twice as likely to use predictive modeling (57 percent versus 31 percent for hospital/health systems).

Health coaching was more often a focus for this sector (100 percent versus 85 percent for hospital/health systems) as were support groups (29 percent versus 15 percent for hospital/health systems).

Source: 2014 Healthcare Benchmarks: Population Health Management

2014 Healthcare Benchmarks: Population Health Management delivers an in-depth analysis of population health management (PHM) trends at 129 healthcare organizations, including prevalence of PHM initiatives, program components, professionals on the PHM team, incentives, challenges and ROI. It delivers the latest metrics and measures on current and planned PHM initiatives, providing actionable data on the most effective PHM tools and workflows, risk identification strategies, tools to boost health plan member and consumer engagement, modalities for program delivery, and much more.

This entry was posted in affordable care act, Care Coordination, Care Transitions, Case Managers, Case Managers and the Patient Experience, Disease Management, Population Health Management and tagged , , . Bookmark the permalink.
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