By: Jaan Sidorov, MD
Is the past (a new) prologue?
That’s the question population health experts should be asking as the profound economic impacts of the COVID-19 pandemic come into view.
Check out this well written piece in the Health Affairs Blog COVID-19 Shocks the US Health Sector. The 2020 statistics described by George Miller and colleagues are remarkable:
- This will be first year ever recorded with a decline in national health spending;
- Admissions for stroke and heart attack decreased independent of COVID-related impacts on bed availability;
- Losses from less elective and non-COVID related hospital care are accelerating hospital prices upward;
- Nursing homes are struggling with a downturn accompanied by a corresponding uptick in homecare arrangements;
- Among physician practices, pediatrics was hit the hardest with important implications for childhood immunizations;
- Pharma has come through relatively unscathed.
However, hidden between these observations are some additional nuggets of information that should be of interest to my colleagues in the population health industry:
- Healthcare spending has grown between 4.35% to 5.6% since 2014, but dropped by 20.1% in April of 2020. In contrast, during that same period, the overall U.S. economy shrank by 31.4%. In other words, U.S. healthcare costs on a relative basis will continue to gobble up more of GDP.
- Hospitals may witness a rebound in 2020 bed occupancy thanks to pent-up demand, but some leading statistics suggest a lingering reduction in admissions that could carry over to 2021. As we heard at the 2020 PHA Innovation Summit and Capitol Caucus, public and private payers as well as investors are paying attention.
- As patient volumes dropped, physician interest in alternative payment arrangements has grown. As a result, provider acceptance of value-based care contracting is poised to go to the next level.
What could this mean for the population health management professionals leading at payers, providers, partners, and solutions companies across the country? While Casey Stengel’s caution about making predictions, especially the future, is apt, some personal expectations are:
- Rising hospital costs and a greater share of employer and government budgets in the face of an economic recovery will accelerate interest in healthcare alternatives. The “boat” of population health – even if it has a short-term cost – will rise as a result of the tide of insurer and investor interest in cost-effective solutions.
- Flagging acceptance of traditional inpatient care will be replaced by growing consumer interest in alternative sites of care. Population health, thanks to its success in delivering care that can be adapted to location or level of service restrictions, will accelerate this transition.
- If growing value-based payment arrangement contracting terms are the prose, then population health management is the poetry. During the Population Health Alliance’s Forum and Summit meetings this year, we heard about the innovative art and science of supporting high-value care for patients and populations. Now that the physician community has growing interest in the topic, we can expect insurers to gain traction with this in their provider contracts. Let this be the call for the population health community to stand ready to help all payers and providers succeed in their goals.
Make no mistake: 2020 has been a terrible year. As we continue to dig out from the pandemic, cost trends, shifts to home care and interest in alternative payment models were already present. It looks like those trends will only accelerate population health in 2021.
Jaan Sidorov, MD is the CEO & President at the PA Clinical Network, he is also President of the Population Health Alliance.
Ms. Polak is a senior director based in Washington, D.C. In her role, she provides policy counsel and analysis to clients with matters involving regu-lations, legislation, and business implications. Anne Marie’s experience includes developing strategic messages and policy positions for Capitol Hill, administration, trade associations, and corporate audiences. Prior to joining Leavitt Partners, Anne Marie was a vice president for Faegre BD Consulting in the firm’s health and biosciences group. She also spent five years with the Podesta Group in Washington, D.C., while completing her law degree in the evenings at the George Mason University School of Law, graduating cum laude in 2010. Anne Marie also worked in the government and legal affairs office of Novo Nordisk in Washington, D.C., and as a congressional aide to Rep. Michael Ferguson of New Jersey.
Dr. Fabius has recently returned to his start up. HealthNEXT, a company dedicated to the development of organizational cultures of health — after serving as Chief Medical Officer of Truven Health Analytics (formerly the healthcare business of Thomson Reuters), the world’s leading source of intelligent information for business and professionals. In this capacity he is charged with developing and deepening relationships with customers, advising on product development, and providing counsel to the leadership on business strategy and medical issues. Formerly, Dr. Fabius served as strategic advisor to the President of Walgreens Health & Wellness Division. This organization will coordinate over 1,000 workplace health centers and 10,000 pharmacies, many with retail clinics, into a seamless primary care network across the country within the next five years. In the not too distant future, it will be possible to offer large employers medical and fitness services on-site as well as episodic illness care, health coaching and disease management monitoring at the employee’s nearest Walgreens pharmacy.
Mr. Buettner is an explorer, National Geographic Fellow, award-winning journalist and producer, and a New York Timesbestselling author. He discovered the five places in the world—dubbed Blue Zones—where people live the longest, healthiest lives. His articles about these places in The New York Times Magazine and National Geographic are two of the most popular for both publications.
Ms. Cooney provides strategic direction for the Centers three Pillars of Population Health – Clinical to Community Connections, Health Equity and the Social Determinants of Health, and Public Health Data Analytics and Informatics. Mary Ann previously worked for 14 years at the New Hampshire Department of Health and Human Services where she was Deputy Commissioner for the Department and Director of Public Health.
Mr. Scully is a General Partner in the Healthcare Group, having joined WCAS in 2004. Before joining WCAS, he was the Administrator of the Centers for Medicare and Medicaid Services (CMS) for three years and the President and CEO of the Federation of American Hospitals for six years. He also served as the Deputy Assistant to the President and as the Associate Director of OMB under President GHW Bush from 1989 to 1993, and has practiced law at Alston and Bird; Patton Boggs; and Akin, Gump, Strauss Hauer and Feld. He is a Principal at the Lincoln Policy Group.
Dr. Don Wright has served as the Deputy Assistant Secretary for Health and Director of the Office of Disease Prevention and Health Promotion (ODPHP) since January 2012. In this capacity, he leads coordination and policy development for public health and prevention activities within the Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services. He is also currently the acting Executive Director of the President’s Council on Fitness, Sports & Nutrition.
Dr. Sidorov is a board-certified in general internal medicine physician with more than 25 years of experience in primary care, inpatient care, medical education and evidence-based practice. Jaan believes physician leadership throughout the continuum of care is the bedrock of value-based care delivery. He received his medical degree from Pennsylvania State University College of Medicine, and completed his internship and residency at the Dartmouth Hitchcock Medical Center in Hanover, New Hampshire. Jaan also served as a Chief Resident at Reading Hospital in Reading, Pennsylvania.
Dr. Ostrovsky is a practicing physician, social entrepreneur, and health policy expert who specializes in human-centered design, lean manage-ment, quality improvement, population health, and digital health. Dr. Ostrovsky was most recently the Chief Medical Officer for the Center for Medicaid and CHIP Services (CMCS), the nation’s largest insurer covering over 74 million people, annually.
Dr. Choice is vice president and medical director for physical medicine services at American Specialty Health (ASH). Dr. Choice oversees the Rehabilitation Services Clinical Quality Evaluation program and leads the content development, training and clinical quality processes for ASH’s musculoskeletal health and pain management products.
Ms. Forte is responsible for leading Tufts Health Public Plans expansion efforts. Prior to her current position, she was vice president of care management for all Public Plans members.
As Director of Strategic Initiatives, Ms. Bowman oversees new social needs intervention initiatives among our clinical partners — including program design, resource database build-outs, and integration of Health Leads’ signature technology, Reach. Elise brings 10 years of direct service experience to her role, having previously served as a Health Leads program manager, a case manager for adults struggling with mental illness and homelessness, and in developing parent engagement initiatives in public education settings.
Mr. Johnson leads the Sage Consulting’s work for a number of public sector, corporate, non-profit and multi-employer clients. David brings particular expertise in evidence-based workplace wellness programs and leveraging Behavioral Economics principles in Human Resources Management. He is also an Adjunct Professor in the Department of Psychology at Towson University.
Dr. Wadhwa is a leader in building population health programs for vulnerable populations. He serves as the senior vice president of market innovation and is the chief health officer for Solera Health where he is focused on scaling the Diabetes Prevention Program as well as health-related, social support interventions. Previously, Sandeep held population health leadership positions with 3M and McKesson. He also served as the State Medicaid Director for Colorado under its former Governor. While there, he oversaw a $4 billion program and led the effort to implement an accountable care collaborative. Sandeep also serves on the board of Reinvestment Fund, a $1 billion non-profit, financial institute devoted to revitalizing low-income neighborhoods. Sandeep continues to see patients at the Seniors Clinic at the University of Colorado Hospital where he serves as associate clinical professor in the division of Geriatric Medicine.
Focused on the intersection of information technology, informatics, clinical medicine and innovation, Dr. Jain is VP and Chief Health Informatics Officer at IBM Watson Health. He was Co-Founder, Senior VP and Chief Medical Officer of Explorys, Inc. formed in 2009 based on innovations that he developed while at the Cleveland Clinic. In April 2015, Explorys was acquired by IBM as an integral component of the newly formed Watson Health business unit. In 2017, he was appointed by Congress to the Federal Health IT Advisory Committee established by the 21st Century Cures Act.
Ms. Maljanian is an accomplished senior executive with more than 25 years of experience in the health care industry. Rose’s leadership experience
John Haughton MD, MS