David Kindig, in a HealthAffairs blog, asks what we mean when we say “population health”.
“Many progressive healthcare organizations are doing cutting edge population health management, but are also working with other partners on total population health across geographic populations, such as the approach Health Partners board has taken in the Twin Cities. In such cases, it would be appropriate to label these efforts as population medicine expanding into total population health.
”Semantics like this can seem arcane, but they also ensure that we clearly understand each other. For the next decade we need to be clear about these two ways of thinking about population health, how they interact, and the important work going on in both of them.”
• To measure the quality and cost of care, payers identify which provider is accountable for which patient. It can be a messy process.
• Most payers attribute patients to primary-care physicians, but a patient with chronic or urgent conditions may see a specialist physician more than a PCP.
• PPO patients can move from provider to provider at will.
• Most attribution depends on retrospective data, usually from the prior 12 months. But that makes it difficult for physicians to predict and address patient needs in the year ahead.
• Nonetheless, some population-health experts say attribution data can improve outcomes.
As H&HN notes, “no matter how attribution is set up, it has the potential to create physician frustration and resistance, especially if it affects the amount of supplemental payments for patient coordination and management, or if doctors are penalized based on results from other providers a patient may see.’