How to Succeed In The Last Mile of Population Health Management

Darline El Reda, Dr.PH, MPH, Director, Analytics Health Plan Solutions, Population Health Management

population health management

When it comes to population health management, having access to the right data is critical. Yet, health care providers and payers often find the variety, volume, and complexity of health care data is a major barrier to delivering efficient and high-quality care. The industry has turned to the technology sector for help.

Problem Defined
No one will argue that today’s technology is allowing us to move unprecedented amounts of data and expedite data organization, allowing us to conduct analysis and create reports faster than ever before. After the tools and technology are in place, countless reports are produced filled with tables, charts, lists, and hundreds (if not thousands) of metrics to measure and track a physician’s “performance.” And, what is even more overwhelming, a physician practice rarely has only one set of technology tools and reports to use given the existence of numerous payers and countless incentive programs – all with their own quality metrics, performance thresholds, measurement time periods, and data collection requirements.

So, now what does a physician do? Unfortunately, many physicians are choosing to do nothing because, frankly, we have made this journey to value-based care too complicated.

Physician Challenges Include

  • No standardization on quality metrics
  • Incomplete transparency on cost-of-care
  • Inconsistency in reporting and performance requirements across payers
  • Extremely complex risk adjustment and quality metric definitions
  • Electronic medical records (EMR) that are increasingly viewed as major disruptors

As a result, millions of incentive dollars are being left on the table and physicians are realizing the “do nothing” approach is not a viable long-term option. And, on the payer side, they are increasingly aware that without adequate physician engagement, they cannot deliver on their promise of high quality cost-efficient care. The results? A stalemate.

 

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Proven Solution
Medical Advantage Group understands what physicians and payers need to do to move past this critical juncture. We have a proven approach to bridge the gap between physicians and payers. We do this by running the last mile with physicians from inside their practices. We are the solution to tools going unused and reports going unread.

We have the skills and expertise required to use the tools and leverage the reports to:

  1. Identify and prioritize relevant cost and quality opportunities, and
  2. Design and implement practice-based strategies leading to success across a variety of incentive programs

We provide education, training, process review, EMR optimization and configuration, and outreach services to support physicians.

We are successful at driving change inside a physician practice because we can offer the collective experience of professionals from many disciplines: information technology experts, epidemiologists, statisticians, nurses, billing and coding experts, EMR experts, care managers, practice workflow experts, and business analysts with decades of experience in health care.