37 Population Health Management Benchmarks

Wednesday, December 26th, 2012
This post was written by Patricia Donovan

Contemplating a comprehensive population health management (PHM) program in the new year? The following data from 2012 Healthcare Benchmarks: Population Health Management may help to shape your initiative. The report analyzes PHM trends for 102 companies, including program prevalence and components, professionals on the PHM team, incentives, challenges and ROI.

Of those 102 respondents, 62 identified their organization type. Of those, 23 percent were disease management/health coaches, 14 percent were health plans and hospital/ health systems, and 8 percent were employers.

Organizations were surveyed in September 2012.

• Organizations that have a PHM program in place: 58 percent

• Organizations that don’t have a PHM program in place but plan to launch one in the next 12 months: 36.4 percent

Areas covered by PHM program:
Health promotion and wellness 83.3 percent
Health risk assessment 68.8 percent
Care coordination/advocacy 60.4 percent
Disease management 75 percent
Case management 66.7 percent
Other 16.7 percent

Populations served by PHM program:
Commercial 85.4 percent
Medicare 47.9 percent
Medicaid 41.7 percent
Uninsured 22.9 percent
Other 14.6 percent

Health risk levels served by PHM program:
All 71.7 percent
Healthy 6.5 percent
Moderate risk 26.1 percent
Complex (5 or more conditions) 19.6 percent
Other 0 percent

Health professionals on the PHM team:
Primary care physician 59.6 percent
Specialist/other provider 36.2 percent
Nurse practitioner 40.4 percent
Case manager 63.8 percent
Registered dietician 34 percent
Health coach 55.3 percent
Pharmacist 31.9 percent
Social worker 34 percent
Other 23.4 percent

Primary method of determining intervention level:
Claims data 33.3 percent
Chart review 8.9 percent
Pharma data 0 percent
Health risk assessment 15.6 percent
Biometric screening 6.7 percent
Electronic health record 8.9 percent
Registry 6.7 percent
Self-report 8.9 percent
Physician referral 2.2 percent
Other 8.9 percent

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