Navigating the value transformation journey: Value-based care delivery models that support integrated population health management

As organizations move to value-based care the risk dynamics change from an operational to a population focus.  Population risk focuses on the value of care delivered to a defined population requiring innovative and transformational care delivery models to manage different risk segments.

The stratification and risk segmentation of the population assists risk-bearing provider organizations in aligning the appropriate population health care delivery models with the clinical needs of the population.  In addition, it allows provider organizations to target investments in improving quality, managing costs and delivering patient-centric care. Miles Snowden, MD, MPH, CEBS Chief Medical Officer, OptumHealth

Population health care delivery focuses on five areas with each area leveraging different clinical care models.

  • Preventative Care – Care delivery is focused on convenience and wellness to promote health for healthy or at-risk individuals.  Examples include: Health Coaches and Wellness Clinics.
  • Primary Care – Refining the traditional practice beyond the patient-centered medical home to support different levels of patient illness. Innovative models evaluate the care delivery team, provider panel size and the intensity of patient care.  Examples include: Ambulatory ICU, Complex Pediatrics and Extensivists.
  • Episodic Care Management – Targeting inpatient and outpatient care for a specific problem that drives efficiency, best practices and clinical integration.  Examples include: Hospitalists, Centers of Excellence, Surgical Focused Factories.
  • Chronic Care Management – Care models and associated care teams that target specific diseases and conditions to educate patients and manage conditions to ensure the highest quality of life for the patient. Examples include: Specialty Clinics, Specialty PCMH, Comprehensive Care Clinics.
  • Post-Acute Care – Integration of post-acute care to support the patient’s continued recovery from illness or management of a chronic illness or disability. Examples include: SNFist, Hospital at Home and Integrated Home Care.

As provider organizations take on risk that requires managing a population, applying new care delivery models will support the goals of the patient, the physician, the employer, the payer and the overall market.

Miles Snowden, M.D.

“Navigating the transformation journey” previous posts:

4 thoughts on “Navigating the value transformation journey: Value-based care delivery models that support integrated population health management

  1. Pingback: Navigating the value transformation journey: Managing population health yields cost and quality improvement | Healthcare Exchange

  2. Pingback: Navigating the value transformation journey: Data and analytics to provide actionable information | Healthcare Exchange

    • I am optimistic that costs will be reduced and that quality will be improved. All of the organizations participating in recent value-based pilots with CMS on Medicare beneficiaries produced improved quality. In addition, while much of the first year of these pilots were spent planning for new cost-reduction activities, a majority of these pilot participants also produced savings compared to expected costs in the first year of value-based work. I am optimistic these models will be an important part of making our health care system more sustainable. Thanks for your interest. –Miles Snowden

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