0 comments on “American College of Lifestyle Medicine (ACLM) is excited to officially join the Population Health Alliance, as we share similar missions and vision for a transformed and sustainable health care system.”

American College of Lifestyle Medicine (ACLM) is excited to officially join the Population Health Alliance, as we share similar missions and vision for a transformed and sustainable health care system.

A blog submission by PHA Board Member and American College of Lifestyle Medicine President Dexter Shurney, MD, MBA, MPH, FACLM, DipABLM

The American College of Lifestyle Medicine defines Lifestyle Medicine (LM) as the combined use of a whole food, plant-predominant diet, regular physical activity, restorative sleep, stress management, avoidance of risky substances and positive social connection in a prescribed synergistic manner as a primary therapeutic modality for the treatment and reversal of chronic disease. While these positive lifestyle habits are an established component of wellness and disease prevention and a core component of Population Health, it’s the most rigorous application of these concepts and their use as “the first-line medicine” that highlights LM’s65 contribution within the larger Population Health family. In other words, LM compliments and helps to enhance the core tenets of the Population Health in powerful ways. We find that the health synergies created by prescribing a therapeutic dose, individualized to the patient, in each of the lifestyle domains simultaneously is the key to breakthrough outcomes. The change to a patient’s health is often so rapid and profound that it can necessitate a simultaneous and rapid reduction in the patient’s prescription medications.

For instance, type-2 diabetics receiving an intensive LM prescription will often need to reduce their insulin dose by one-half within the first week of treatment to avoid a potentially harmful medication overdose (hypoglycemic) situation. Because of this often-rapid change for the need of medications, partnership with an appropriately trained LM practitioner is important, working hand-in-hand with other population health teammates, to provide the proper patient support and education is ideal.

LM is a powerful intervention, for the simple fact that lifestyle is at the center of so many common chronic conditions like heart disease, type-2 diabetes, pre-diabetes, obesity, dementia, and cancer. Therefore, a single but comprehensive LM intervention can be used to treat multiple disease states. For example, the type-2 diabetic that is experiencing a reduction in the need for insulin will also see an average reduction of 20% in their cholesterol numbers within 7-8 weeks, assuming their cholesterol was elevated to start with. When explaining LM I sometime use the analogy of vegetable gardening. When a plant has the proper soil, sun exposure, and water (not too much/not too little), the entire plant is healthy. The same is true for the human organism. Given the proper sleep, physical activity, nutrition, stress, etc. we see improvements in all the most common chronic conditions (diabetes, obesity, hypertension, heart disease, etc.), i.e. the “entire” human organism becomes healthy. It makes sense that for the 80+ percent of preventable chronic conditions that are rooted in poor lifestyle, that a lifestyle directed treatment option would prove to be tremendously effective.

Population health is a team sport. The complimentary role of Lifestyle Medicine as part of the Population Health Management framework is of vital importance and cannot be overemphasized.

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About ACLM: Founded in 2004, the American College of Lifestyle Medicine (ACLM) is the medical professional society for physicians and other professionals dedicated to clinical and worksite practice of Lifestyle Medicine as the foundation of a transformed and sustainable health care system. ACLM educates, equips, empowers and supports its members as they provide evidence-based Lifestyle Medicine as the first treatment option in clinical practice and worksite settings through live and online CME-accredited events and educational offerings, certification, clinical practice tools, patient education resources, economic research, networking opportunities and advocacy efforts.

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0 comments on “The Population Health Alliance Announces Senator Braun of Indiana as a Keynote Speaker at Their Annual Innovation Summit and Capitol Caucus”

The Population Health Alliance Announces Senator Braun of Indiana as a Keynote Speaker at Their Annual Innovation Summit and Capitol Caucus

The Senator will highlight the unique role of the employer in driving innovation in Population Health.

Washington, DC, September 12, 2019 –(PR.com)– Population Health Alliance (PHA), the health care industry’s only multi-stakeholder professional and trade association solely focused on population health, today announced that Senator Braun of Indiana has agreed to deliver remarks at their annual Innovation Summit and Capitol Caucus on October 29 in Washington, DC.

Before being elected to the Senate, Braun built a truck parts and accessories business in his hometown and grew it from three employees to nearly 1000 employees nationwide. His company built a unique health care plan that engaged employees in their own healthcare, encouraged shopping around to find the lowest prices, prioritized wellness, and covered pre-existing conditions with no caps on coverage. Braun held health insurance premiums on this plan flat for his employees at 70 dollars a month for ten years running.

Since being elected to the U.S. Senate. Braun has been vocal about the critical need for transparency in the healthcare marketplace so that working families have the information needed to make their best health care decisions. He has introduced several pieces of novel legislation on healthcare issues, some of which he has already shepherded through the Committee on Health, Education, Labor & Pensions (HELP) in his first year.

“We are honored to have Senator Braun join us as a keynote speaker at our important industry event. Senator Braun’s experience in the private sector to improve health and manage costs and his passion for fueling policy with innovation is sure to arm our attendees with insightful takeaways to advance their own organizations,” said Rose Maljanian Chairman and CEO HealthCAWS and Chairman of the Board, Population Health Alliance.

About the PHA Innovation Summit and Capitol Caucus:

Join the Population Health Alliance’s 2019 Innovation Summit and Capitol Caucus to engage in in-depth conversations about today’s biggest population health opportunities and solutions. The Summit will bring together both stakeholders and policymakers from across the health care industry committed to advancing results in care management, wellness, and prevention for collaborative learning, lesson sharing, and policy & regulatory briefing. This year’s focus on combating the impacts of financial security as the common denominator across social determinants and populations will highlight innovative solutions being advanced in the field and will present attendees with actionable items for their work as they move toward 2020.

PHA represents stakeholders from across the health care ecosystem that seek to improve health outcomes, optimize medical and administrative spend, and drive affordability.

Population Health Alliance
Brent Ling
202.737.5476
bling@populationhealthalliance.org
www.populationhealthalliance.org

0 comments on “BMA ALLY BLOG: Deploying Value Based Care Contracts Under the Umbrella of Population Health Management: A Must for Success”

BMA ALLY BLOG: Deploying Value Based Care Contracts Under the Umbrella of Population Health Management: A Must for Success

The following article was published by the Better Medicare Alliance and was authored by Rose Maljanian, Chairman & CEO HealthCAWS Chairman of the Board at the Population Health Alliance. PHA is an active member of BMA’s Ally Network, and the original posting can be found here.

Join us in Washington, DC on October 29th for PHA’s Innovation Summit and Capitol Caucus to hear directly from both Rose and BMA’s President and CEO Congresswoman Allyson Y. Schwartz as they take a deeper dive into the innovations in population health management for senior populations. Register today and use promotional code BMA20 for a special 20% discount off registration.

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August 14, 2019
Rose Maljanian, Chairman & CEO HealthCAWS
Population Health Alliance

The evolution of our nation’s healthcare system and ecosystem from fee for service to value based care has only just begun, and while the goal is to rapidly accelerate the membership under value based care payments, it will be a long journey to refine the model. Legislation, market driven mergers and disruptive innovation from industry veterans inside and outside of healthcare focused on the consumer are contributing to what at times feels like a roller coaster ride. At the center of all of this is the growing population of seniors who largely receive their health benefits from the government, either directly or indirectly, through managed Medicare, Medicaid or Dual-eligible programs. Seniors as customers want and demand choice, convenience and value as consumers do in other markets and industries. The focus on these three elements is fundamental to any business strategy. However, necessary but distracting details, including type of legal entity, payment rates, payment flow, shared savings methodology and disbursements can completely envelop the airtime in leadership meetings. Alternatively, framing value-based care under the umbrella of population health management supports a focus on seniors’ needs and wants and the strategies that result in affordably achieving optimal health for these populations.

Understanding payment models as financial lever of alignment

Value-based care payment models have been aggressively advanced by CMS and commercial payers over the last several years. CMS’s stated purpose is to transform the health care system through innovation by paying providers for quality versus quantity of services delivered. Whether the program is a CMS program such as Advanced Payment Models (APMs), Merit-based-Incentive Payment System (MIPS) or a value-based contract as part of a commercial payer network, the payment method is simply put, the financial lever to align the care provided with outcomes-quality, experience and cost of care savings.

Virtually all value-based care models promoted or reporting positive results deployed the key elements of the population health management model to achieve success. Under current CMS value-based payment models1 and those proposed for 2020 and beyond2, quality improvement strategies and population health metrics such a readmission rates are prescribed with advancing flexibility to reduce burden and achieve desired value.

In terms of results, Humana reported significant improvements in numerous quality metrics and 23.4% fewer inpatient hospitalizations and 15.6% fewer emergency room visits under value-based care arrangements in Medicare Advantage members. In their report3, they attribute the improvements to population health management infrastructure and strategies such as proactive outreach and whole person management. Aetna similarly cited tools, infrastructure and approaches common to population health management as important to the success of their accountable care organizations. With Banner Health for example their Aetna Whole HealthSM program achieved 24 percent decrease in avoidable surgery admissions, a 4 percent increase in generic prescribing, and a 11.5 percent overall reduction in medical costs.4

In order for the end result to be a value-based contract that produces a positive net income versus one that adversely effects the organization financially, a solid population health management strategy must be deployed, tightly managed and iterated as populations and market conditions evolve. Furthermore, without a positive consumer experience and health outcomes, retention of patients/members in a practice or plan is likely to suffer, further eroding the chance of success.

Staying true to the principles of population health management (PHM)

There are three enduring components of the population health management model:1) defining and understanding the population for which the organization holds accountability; 2) a portfolio of evidence based solutions that can be tailored to individual need at any given point in time and 3) measureable outcome results. The Population Health Alliance outlined a value focused framework for Population Health Management more than ten years ago that included these elements with consumers at the center.5

Defining the population up front (assigned vs attributed) allows organizations to understand their populations, stratify risk and preference for engaging so that when crafting and triaging individuals to programs and tools, the programs and tools are those that consumers want and need.

Programs and tools must be available to address the full continuum of care whether to maintain health, address an acute event, support chronic care management or support comfort at end of life. Furthermore, solutions must include a multifaceted approach depending on where an individual is on the care continuum, their life goals and their preferred means of engaging. Studies by the PEW Research Center have demonstrated consistent increasing uptake in technology for seniors6,7 including 53% owning a smart phone and 59% having broadband access.7 Addressing barriers such as trust, cost and tech support will likely fuel further adoption among all income and educational levels. In recognition of this trend, many organizations are deploying blended high touch and high tech strategies in their senior health programs.

Finally, a focus on the endgame of outcomes across populations will ensure success with multiple value based contracts. The population health management model has always had a focus on outcomes that include clinical, utilization, satisfaction and experience of care and cost metrics. When staff deploy consistently high quality evidence based care that achieves consumer goals, the likelihood of missing mutually agreed-to standard metrics in a value based arrangement as a result of inconsistent care, lack of consumer engagement or gaps from confusion when doing different things for different populations is bound to decrease.

Executing well on solutions that solve needs and preferences

The need to execute well in a world of high visibility of alternatives for care, experience ratings and mounting pressure on cost transparency cannot be overemphasized. Executing well no longer means getting ID cards and EOBs out on time and finding an opening for the consumer in the same week to be seen by a PCP or specialist. It will command listening to what consumers desire to achieve, such as return to playing tennis, being able enough for air travel, controlling their diabetes versus diabetes consuming their life with too many appointments and tests, reducing days not feeling well enough to enjoy getting out and living life or just living long enough to see a marriage or birth. Furthermore, living life involves conserving seniors’ financial resources as well through optimized care, lower total cost of medications and value-added supplemental benefits such as concierge services and care management, home modifications, light housekeeping, transportation and nutrition support. Scan Health Plan recently announced expanded benefits for seniors to age in place at home. This followed a market survey confirming the trend in which 88% of their addressable market in Southern California expressed a desire to stay in their homes.8

As leaders, promoting common understanding of what it means to deliver value and how to get there

As leaders we need to guide the discussion on value amongst our colleagues, all payers and the public at large. Value based care is not about the contract itself. The contract is a financial lever under the umbrella of population health management. it is about delivering value (quality and affordability) to each healthcare consumer, the payer customer, and keeping those that bear risk whole and flourishing as they serve at the front line of healthcare transformation.

References

  1. CMS Value based care programs https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/value-based-programs/value-based-programs.html updated 5.17.2019.
  2. CMS QPP Resource Center https://qpp.cms.gov/about/resource-library updated 7.29.19.
  3. The Intersection of Heath + Care: Value Based Care Report 2018. http://valuebasedcare.humana.com/wp-content/uploads/2019/04/2018-VBC-Report.pdf
  4. Accountable care organizations: Transforming care delivery to support members, increase cost savings https://news.aetna.com/2018/02/accountable-care-organizations-transforming-care-delivery-support-members-increase-cost-savings/ February 12 2018
  5. Population Health Alliance Population Health Management model https://populationhealthalliance.org/research/understanding-population-health/
  6. Anderson M and Perrin A. Tech use climbs among seniors. Pew Research Center May 17, 2017 https://www.pewinternet.org/2017/05/17/technology-use-among-seniors/
  7. Anderson M. Mobile Technology and Home Broadband 2019 Pew Research Center June 13, 2019 https://www.pewinternet.org/2019/06/13/mobile-technology-and-home-broadband-2019/
  8. SCAN Health Plan Addresses Seniors’ Desire to Remain at Home With Expanded Benefits, Reduced Costs Nov 14, 2018, https://www.prnewswire.com/news-releases/scan-health-plan-addresses-seniors-desire-to-remain-at-home-with-expanded-benefits-reduced-costs-300750108.html
0 comments on “HealthEC Joins Population Health Alliance”

HealthEC Joins Population Health Alliance

Washington, DC, August 01, 2019 — Population Health Alliance (PHA), the health care industry’s only multi-stakeholder professional and trade association solely focused on population health, today announced that HealthEC (HealthEC.com) has joined the organization as a member.

A 2019 Best in KLAS provider of population health management technologies, HealthEC helps customers succeed with value-based care by offering a flexible, single-platform solution that aggregates clinical, claims and quality data, and provides actionable insights that can improve health care outcomes. KLAS recognition is important to population health technology providers because it is a third-party validation of service quality and acknowledges provider efforts to help health care professionals deliver better patient care.

“We are pleased to welcome HealthEC as a member of the Population Health Alliance. We were impressed with their KLAS ranking as well as the tremendous leadership that President and CEO Arthur Kapoor provides to the industry at this important juncture for digital transformation,” said Rose Maljanian Chairman and CEO of HealthCAWS and Chairman of the Board for the Population Health Alliance. “We look forward to Arthur and his executive team participating in important PHA initiatives including policy and advocacy, quality and research, and uniting the population health community through membership, learning and networking events,” added Maljanian.

“Advancing population health and value-based care is a top priority for HealthEC and we are pleased to align with an organization dedicated to these objectives,” said Kapoor. “The Population Health Alliance plays an important role in our evolving industry and we invite our fellow population health solution providers to join us at PHA.”

PHA represents stakeholders from across the health care ecosystem that seek to improve health outcomes, optimize medical and administrative spend, and drive affordability.

Population Health Alliance
Brent Ling
202.737.5476
staff@populationhealthalliance.org
www.populationhealthalliance.org

0 comments on “PHA Announces 2019 Innovation Summit and Capitol Caucus in Washington, DC”

PHA Announces 2019 Innovation Summit and Capitol Caucus in Washington, DC

Improving Health Through Financial Security: The Common Denominator Across Social Determinants and Populations

2019CaucusLogo
Washington, DC — The Population Health Alliance (PHA) announced today that their annual Innovation Summit and Capitol Caucus will be held on October 29, 2019 in Washington, D.C. This year’s theme, “Improving Health Through Financial Security: The Common Denominator Across Social Determinants and Populations” will give the much needed focus to the latest risk-analyses, innovative intervention efforts, and targeted health and cost outcomes achieved, presented by our group of national experts; including:

Congresswoman Allyson Y. Schwartz, MSW – President and CEO, Better Medicare Alliance
Peter Skillern – Executive Director, Reinvestment Partners
Patricia Hasson – President and Executive Director, CLARIFI
David Hoke – Sr. Director, Associate Health and Well-being, Walmart
Ralph Gildehaus, JD – Senior Program Director, MDC Inc.
Laura Samuel, PhD CRNP – Assistant Professor, Johns Hopkins School of Nursing
Mike Criteli, JD – Retired CEO from Pitney Bowes, Entrepreneur, Health Care Consultant, Feature Film Producer, Speaker

The Population Health Alliance Innovation Summit & Capitol Caucus 2019 will gather key stakeholders from across the health care industry and D.C. area policymakers committed to driving innovation in care management, wellness, and prevention for focused briefings on high-impact legislative and regulatory issues. PHA members will focus the critical discussion on social determinants of health on the heels of the release of the Quality and Research Committee’s eBook, “Social Determinants of Health and Health Disparities,” and will have substantial opportunity to network with the event speakers, PHA Board of Directors, and a diverse group of industry leaders and policy decision makers.

“The theme of our Innovation Summit this year could not be more timely as the industry has been awoken by the evidence linking financial security and other nonclinical factors to health and cost outcomes. The issue is cross cutting amongst employees, seniors and others participating in government sponsored programs. PHA members and constituents are leading action with innovative solutions to solve this important problem.” Rose Maljanian Population Health Alliance, Chairman of the Board.

Join us at the Population Health Alliance 2019 Innovation Summit and Capitol Caucus to engage in in-depth conversations about pressing population health challenges and solutions. To register for the Innovation Summit and Capitol Caucus 2019, visit https://www.eventbrite.com/e/pha-innovation-summit-and-capitol-caucus-2019-tickets-62271226916.

Not a PHA member? Join PHA Today!

About Population Health Alliance:
Population Health Alliance (PHA), a corporate 501(c)6 nonprofit organization, is the industry’s only multi-stakeholder professional and trade association solely focused on population health management, representing stakeholders from across the health care ecosystem that seek to improve health outcomes, optimize the consumer and provider experience and drive affordability.