Does Population Health Make Sense (for you)?

The interest around accountable care and population health management continues to grow and an increasing number of hospital and physician organizations are investing significant financial resources in developing the underlying capabilities.  But does that investment really make sense?

Many questions should be answered before updating data systems, aligning physicians, and pursing Medicare or commercial opportunities.  Let’s consider a few:

·         Is the proposed population to be managed large enough and the potential savings significant enough to cover your costs?  The bulk of “savings’ are tied to about 5% of the target population.  This means in a 5,000 member group about 250 folks need to avoid costs to a level that meet or exceed your expenses.

·         Are your physicians philosophically aligned with you in believing that the undertaking is worth the efforts and that the rewards are attainable?

·         Are the data available from you proposed partner at a level of detail that will allow you to target that 5%?

·         Are their alternative approaches to “VALUE”, such as gain sharing, medical homes, or case pricing that have a better chance of success?  Should you start small and grow as you learn to manage care?

Every market is different and the path ahead is far harder and more expensive than you might think.  Early experience in the ACO environment is not a compelling argument for diving into the water without careful thought; unless you simply view the exercise as a learning experience.

Want to talk about what we have seen work (and not work)? Email Greg Mertz, Managing Director, at gmertz@physicianstratgiesgroup.com and let him share our experiences.

 

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