Population Management Approach Enables Targeted Treatment for Chronic Conditions

April 1, 2021
April 1, 2021

Population health is a very important tool in the effort to provide better care for people with chronic conditions. This is the message of the HealthStream article, Manageable but Often Overlooked: Chronic Disease Treatment Will Play a Vital Role in Effective Population Health Efforts. Here’s our final excerpt from the article:

Population Management Allows for Targeted Treatment

Treating any or all of these conditions effectively requires the adoption of a population health management, or PHM, model. This is defined as a focused approach to improving the health outcomes of a specific subset of patients sharing similar health challenges or conditions. Some ways these groups can be further divided is by:

  • Healthcare system or insurance plan
  • Geography/location
  • Specific disease
  • Other unique and shared characteristics

The rise of the PHM model has accompanied the ongoing move away from fee-for-service patient care and toward the value-based model, which rewards twin goals: cost control and improved outcomes. Participants include insurance providers, quality improvement agencies, healthcare systems, and healthcare providers, all of whom are applying public-health concepts to chronic disease management by obtaining and using data to hone in on the most effective methods that achieve the desired results.

A solid PHM plan includes:

  • Strong data collection and IT for analysis
  • Care management that is cohesive and features well-managed objectives such as patient compliance and self-motivation
  • The creation of subpopulations around health, lifestyle and medical history so that providers can further understand needs and trends
  • Complete, comprehensive patient population profiles to assist with identifying patients at risk for readmission and to create patient-specific care plans
  • Data sets for patient notification, appointments, and other touchpoint engagements so that patients have a higher level of engagement, education and participation in their care.

As Demographic Changes Make the Chronic Condition Challenge Larger, Population Health Will Be Even More Essential

For all these reasons and more, chronic disease management is an essential component of any overall population health management effort. Those engaged say that it often feels like trying to turn back the tide with a teaspoon, yet they remain hopeful because they see how well education and outreach can work alongside comprehensive care strategies. They also know that things may get worse in the coming years, as the aging Baby Boomer population crests and other social forces come into play, and so caregivers are bracing for that impact.

“The American Diabetes Association puts out standards of care every year, and recent ones did show a slight decrease in people being diagnosed,” Sharecare’s Carden says. “We’re not sure if that’s because of better medication, or people becoming more knowledgeable about causes and doing a better job with diet and exercise, but it’s good news. Even so, the experts are predicting a continual increase with diabetes and some other conditions over the next few years, so things may still get pretty bad. We are going to have a lot to do for these people.”

This article also includes:

  • Focusing More on Populations That Require More Care
  • Demographic Urgency: Growing Senior Population Provides Impetus for Quick Action
  • About Chronic Medical Conditions
  • No Magic Bullet, No Single Approach Method

Download the full article here.