Views split on population health benefits

Views on the importance on population health differ depending on how you interact with patients, according to a survey of healthcare executives and clinicians.

The New England Medical Journal (NEMJ) Care Redesign survey, released in March 2016, asked 297 people of various healthcare backgrounds about clinical practices changes and evolution, and how it might affect healthcare in the near future. Almost 45% of respondents were clinicians, 29% were executives and 27% were clinician leaders.

Survey participants were asked to rate the importance of population health on a scale of zero, meaning it’s a fad, to 100, meaning it’s critical to the future. The average of respondents rated population health at 77. More than 40% of respondents rated population health at 100. Twenty-three percent of respondents rated population health between a 50 and 74.

Compton-Phillips

“While 77 squeaks into the top quartile, that was a C grade in high school. It is a tepid endorsement for something that so many organizations are betting on heavily,” says Amy Compton-Phillips, MD, member of the NEMJ Catalyst Leadership board, and executive vice president and chief clinical officer of Providence St. Joseph Health.

Compton-Phillips says that the survey showed that executives had more favorable views of population health than clinicians. “This is due to executives seeing population health strategies as a way to control costs, while clinicians viewing them as a way to change focus from personal, patient care,” she says.

The NEMJ survey also included written responses from clinicians and executives who were asked about population health. Compton-Phillips says that those responses give more insight to the challenges between what executives and clinicians think about population health.

“So far, I have not been impressed with the vision nor the outcomes of current population health research and programs,” said a clinician at a nonprofit post–acute care provider in the Mid-Atlantic region.

“The risk to overemphasizing population health is that some interventions may not have desired outcomes so there needs to be focused efforts on areas that have a proven benefit and avoid focusing on outcomes without demonstrated benefit. It’s not a magic bullet and won’t replace the therapeutic relationship that can [be] between a patient and a trusted physician,” said a clinician at a small, for-profit clinic in the South.

Executive responses often focused on more long-term benefits of population health strategies.

“Population health management is key to enabling people to take control of their healthcare needs. As the number of hospitals shrinks and the population ages there needs to be a mechanism in place by which providers and patients remain linked,” said an executive at a large, nonprofit community hospital in the Northeast.

When surveyed about the best short-term and long-term ways of improving the health of communities, investing in ways to link behavioral health to physical health was the top improvement. Only 11% of survey respondents cited investing in tools for physicians (including population health tools) as a short-term solution, and 13% agreed that it is a viable long-term solution.

Ultimately, redesigning care management is more than just one new idea, it is a collaborative effort between stakeholders on all sides of the healthcare landscape, Compton-Phillips says. Nearly 62% of survey respondents said that they will be adding population health infrastructure to their organization in the next three to five years, without adding any net costs to the healthcare system.

“I believe the right path is in the middle. Like virtually any tool, population health can have wonderful uses at the right place at the right time. When doctors and patients understand the evidence-based gaps in routine primary and secondary prevention, the right care is much easier to provide (and receive),” Compton-Phillips said in a blog post about the survey.