Population health a top concern among healthcare leaders

Population health was a hot topic at the 2014 American College of Healthcare Executives Congress in Chicago this week, with healthcare leaders from around the nation and world sharing ways to improve health under value-based care initiatives.

Peter Bernard, CEO of Bon Secours Richmond (Va.) Health System, said his organization tackled it by focusing first on employee wellness programs. The hospital started an incentive program that allows employees to earn an extra $900 a year if they participate in health and biometric screenings, risk assessments, health coaching and health goal settings. The program initially focused on high-risk employees who showed signs of obesity or diabetes. Now it includes low- and moderate-risk employees and their families.

Other initiatives include a cycling program, installation of walking paths and a dedicated web portal for wellness. In addition, the hospital will only hire non-smokers to work at its facility, according to Bernard.

By adding incentives to good health, the hospital's employee participation in preventive health programs jumped from 40 percent to 95 percent, Bernard said. In addition, the hospital saw a decrease in emergency department use after it opened its Good Health onsite clinic to treat employees and their dependents for non-emergency illnesses. And, he said, Bon Secours Richmond received a $7 million rebate from its insurance company because its employees were healthier and used less services. 

The organization hopes to roll the program out to the rest of its facilities across the country and create a model for population health. "These are some of the high level activities that helped us get a handle on our costs," Bernard said.

At UCLA Faculty Practice Group and Medical Group in Santa Monica, Calif., CMO Samuel Skootsky, M.D., and his team create high-performing patient-centered teams to foster a coordinated care effort that targets population health. He said it is healthcare leaders' responsibility to accept the risk for populations, as well as the role of "integrator of care."

His organization used the primary care innovation model, in which it implemented practice redesigns, increased covered lives under UCLA management, expanded primary care capabilities and collaborated with retail clinics to improve coordinated care. The model relies heavily on care coordinators, who contact patients after discharge to ensure they follow instructions from physicians, schedule follow-up appointments and adhere to medication prescriptions, Skootsky said.

Emergency department care coordination also plays a role in population health management, said Marlene Bober, R.N., administrator of acute enterprise care management for Advocate Health Care in Illinois. Her organization educates both patients and physicians about the potential to treat patients at primary care sites as opposed to the emergency department, and also created care plans for frequent users of the emergency room. 

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