Now that open enrollment is underway for Affordable Care Act exchange plans, the focus is turning to what insurance companies are planning for the upcoming year, including how they plan to manage population health. To find out what's in store, Managed Healthcare Executive asked four health plan executives about their goals and priorities.
As FierceHealthPayer previously reported, major payers are increasingly focusing their efforts on population health, which has quickly become a multi-billion dollar endeavor.
Though each organization featured in the article had its own unique strategy, a common theme expressed by the four executives was an increased focus on a holistic approach to medicine that focuses on the whole patient. In giving patients more control over their own health, insurance companies will reap long-term financial benefits, according to the report.
"We are aligning our benefit designs to create incentives for our members to be more receptive and engaged in their own care," said Donald Liss, M.D., vice president for clinical programs and policy at Independence Blue Cross. "If we do our job right, our payment models, our information resources and our plan designs will mutually reinforce one another."
Additionally, executives who spoke to the publication say it's important to keep communication open, use analytics to predict readmission numbers and reward physicians who do this in the most cost-effective way.
They also provided advice to insurers looking to implement population health management within their own systems, suggesting that they provide physicians with incentives for establishing chronic disease prevention management programs, and develop innovative community-based solutions for addressing determinants of health. The focus should be on patients' future health, rather than just their immediate needs, and there should be increased commitment to overall population health, the executives said.
"A comprehensive program considering all the conditions of a member yields better results with higher satisfaction," Bob Gladden, vice president of the center for analytics at CareSource, said in the article.
To learn more:
- here's the article