Population health management needs non-profit hospital trustees' cooperation

As healthcare transitions from its traditional fee-for-service model to a value-based system, non-profit hospital trustees must overcome their aversion to the short-term high cost and risk of focusing on population health management, argues a commentary published in JAMA.

The fee-for-service mindset is deeply ingrained in many non-profit hospital trustees, writes Michael Jellinek, M.D., of Burlington, Massachusetts' Lahey Health Community Network. Board meetings typically emphasize fee-for-service measures such as admissions volumes and outpatient visits. Moreover, non-profits often get by on razor-thin operating margins, making trustees reluctant to make the up-front investments necessary for population health management. Despite these hurdles, Jellinek writes, non-profit hospitals simply can't align operations with their missions without incorporating population health management strategies.

So how should trustees move forward on population health? Several steps are essential, according to the commentary, including:

  • Holding frank conversations about potentially tough choices
  • Focusing on initiatives that bridge the goals of population health management and fee-for-service, such as readmission reduction
  • Developing metrics specific to population health management
  • Fostering teamwork in various sectors, including care coordination, primary care and population health management programs

However, these steps are only the beginning if trustees are to successfully transition their organizations to value-based care, Jellinek cautions, as the necessary investments and financial risk mean barriers will still remain. "Those who pay for care--the government, insurers, and employers--will need to facilitate a prudent and viable path that encourages boards of trustees to replace the incentives and culture of fee-for-service with the values of population health management," he writes.

While healthcare leaders agree that the industry must devote more attention to population health management, far too many of them are still "testing the waters," according to a recent survey.

To learn more:
- read the commentary