The Gorilla of Pop Health

What Does a Population Health Strategy Look Like?

Population health management (PHM) has grown into something of the King Kong of healthcare: massive, powerful, and - if we’re being honest - pretty hairy.

As providers and vendors have come together at KLAS’ recent summits on population health, we have managed to unpack and quantify the population health space to some extent. Through that process, some major themes and keys to success have emerged.

THE COMPLEX AND CUSTOMIZED NATURE OF PHM

Nearly every consumer of PHM solutions is in a unique position. There are differences in organization size, payer makeup, risk-based models, competitive landscape and experience with value-based-care delivery, to mention a few. Because of this, providers struggle finding PHM tools that are tailor made.

As we’ve hosted summits on this subject, we find that Vendors and Providers don’t always see eye to eye. Providers feel that when a vendor has successfully delivered a solution to other (very different) healthcare organizations, the vendors then overestimate their ability to deliver to any healthcare organization, leaving providers feeling that their unique needs aren’t met.

On the other hand, vendors often feel that providers overestimate how unique their needs really are. Clearly, there is a need for vendors and providers to come together and better understand each other as vendor-provider partnerships will be critical to the maturing market of PHM.

Additionally, PHM becomes increasingly hairy when we realize that the term “population health” means many different things to different people.

 To measure this complex area KLAS, by facilitating collaboration between vendors and providers, created a framework with six verticals to help providers navigate this broad and complex space.

To measure vendor performance in this market, we have to cast a broad net. We expect that in order to help providers be successful in population health, PHM tools must have a broad spectrum of functionality and as KLAS moves forward, that’s how we plan to measure the space. Now that we have a framework to measure with, we hope to help improve the industry rapidly and help providers and vendors find population health success.

THE NEED FOR PHM PARTNERSHIP

At the most recent KLAS Population Health Summit, our provider panel urged vendors to face the reality of the challenges around moving into PHM. Providers often feel that vendors downplay how difficult it can be to establish effective population health solutions. This can lead providers into unrealistic expectations around how quickly their PHM tools will go live, resulting in a jarring realization when reality hits. Providers want more transparency, so they can better prepare and set the right expectations within their own organizations.

With regard to implementations, providers also expect their vendors to be experienced enough to help give them an idea of where the solutions are going and what it will take to get there.

Tied to this is the expectation that vendors will bring best practices with them. Providers don’t want to reinvent the wheel and, if possible, want to avoid the time and cost associated with learning from their own mistakes.

Vendors can and often do play a key role in helping to guide providers down the path, avoiding potholes and other obstacles along the way. As vendors act more in this capacity, providers tend to see them more as partners and less as vendors.

Providers are also looking for partners to create tools that fit within users’ standard workflows so that they don’t have to retrain all their employees on yet another separate system. More than anything, providers want a vendor that has a road map to success and will partner with providers along the way to meet their needs.

Vendors are interested in meeting those needs, but they have a better understanding of how difficult it is to really make everything work well together. They understand that in order to build solutions that really integrate, they need cooperation from other vendors, and they need a financial commitment from the providers, both of which tend to be difficult to obtain.

We’re excited to say that since that 2016 summit, our work in the PHM world has not stopped. We’ve got lots more to share in the coming weeks!