Population Health Management Jan Simon, MHSA, RN Lead Faculty Health Care Management

Definition of Population Health Management (PHM) Population Health Management (PHM) is a rapidly emerging specialty area within health care management It is focused on improving the health status of defined populations PHM programs include care coordination, behavior change, use of technology and data, and outcomes measurement

The Concept of Population Health “Population Health is the distribution of health outcomes within a population, the health determinants that influence distribution and the policies and interventions that impact the determinants.” (Kindig D, Stoddart G. What is population health? American Journal of Public Health, 2003) It’s a snapshot of the health status of a group of people, and what contributes to it.

Managing Population Health Defining the population: Who is included in the population we want to manage through a PHM program? Identifying risk: What health problems or risk factors do they have? What social issues? Designing a program: Care coordination; disease management; wellness coaching Measuring outcomes: Did health status improve? What was the cost?

Links to Health Reform Health Reform, also referred to as the ACA (Affordable Care Act), changes the way providers are paid This includes hospitals, clinics, physicians, and insurers Payment will be based on outcomes not on process (or what services are provided) Fee for Service is being phased out

Who is involved in PHM? Clinicians are trained to manage patients Physicians, Nurses, Social Workers, Therapists Health coaching is an important aspect Helping patients adopt healthy lifestyles and behaviors is key to improved health outcomes PHM is a partnership between patients and providers

Administrative Needs Designing PHM Programs Using large data sets to identify the population, its risks and disease prevalence, social, economic and environmental factors that affect health status Creating valid outcome measures and reporting on them Measuring return on investment of programs

Current Academic Programs Very few degree-granting programs exist at this time for administrators to gain the knowledge and skills necessary to implement PHM programs Clinicians are reading about PHM and attending conferences for information There is likely a disconnect between clinicians and administrators re PHM

Ottawa’s Response A new track was approved by UAC in Fall of 2014 The PHM track consists of 4 courses of 3 credits each Population Health Management Health Informatics Program Development for Improved Outcomes Return on Investment for Health Care Programs

Population Health Management BUS 7810, taken in Module 1 Provides an in-depth overview of PHM as a discipline, its components and business applications. Covers the PHM paradigm, principles of behavior change, health system navigation and continuity of care. Addresses the business case for PHM, IT decision support, policy implication and ethical dimensions, using models of care management and research

Health Informatics BUS 7813, taken in Module 2 Explores the use of health information technology from a system perspective. Utilizes a case-study approach to illustrate the use of large data sets to identify at-risk poppulations and to segments defined populations by health status and cultural characteristics

Program Development for Improved Outcomes BUS 7816, taken in Module 3 Provides practical applications of strategies to improve the health status and outcomes of defined populations Prepares the student to design and implement PHM programs in the health care setting

Return on Investment for Health Care Programs BUS 7819, taken in Module 3 Examines methodologies for managing and evaluating programs in PHM using an actuarial approach Analyzes financial management of health care programs, cost savings and improved outcomes

Candidates for the track Health Care Administrators who want to focus on the creation, management and measurement of PHM programs Physicians and Nurses who want to shift from clinical care to program administration MBA students who want to enter Health Care and need a specific skill set Ancillary providers interested in Administration

Job outlook Population Health Management is one of the fastest-growing areas in health care It is becoming a necessary core competency PHM jobs exist in hospitals, clinics, MCOs, ACOs, Provider Organizations, insurance companies, state and federal government, non-profit agencies and a growing number of settings Expected growth: 21% in the next decade

Courses for PHM and HCM PHM HCM Population Health Management BUS 7810 Health Informatics BUS 7813 Program Development for Improved Outcomes BUS 7816 Return on Investment for Health Care Programs BUS 7819 Global Health Care Delivery Systems BUS 7300 Legal, Ethical and Political Aspects of Health Care Management BUS 7303 Regulatory Systems and Qualitative Assessment in Health Care Environments BUS 7305 Communicating Change in HC Organizations BUS 7309