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Case Study - Population Health Management

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Summary: One of the south's largest health plans developed a population health quality improvement program. The program focused on management of chronic conditions to improve patient health outcomes and reduce costs. The plan utilizes SPH Analytics' Population Careā„¢ Patient Registry and Population Health solution to help practices identify, manage, and improve the quality of care for their patients as well as reduce costs. Results indicate that program has made a positive impact on chronic disease management with improved health outcomes and lower healthcare costs. Background: The U.S. is facing a serious issue of high healthcare costs and lower quality health outcomes. This dilemma is even greater for the state where this health plan is based. A significant driver of the state's high healthcare costs and poor health outcomes is the large number of patients with chronic diseases. The plan already has a long-standing record of working with their physicians and physician practices to improve the health of its patients and members through support services and quality improvement programs. The health plan also realized the need for a powerful population health tool to drive their quality improvement program at this time. Challenge: As mentioned, the high number of patients with chronic disease conditions is a significant factor in the state's high healthcare costs and poor health outcomes. Furthermore, these problems are naturally expected to increase over time unless effective interventions are developed. Another significant challenge for the plan was that healthcare systems across the continuum of care were not set up to effectively manage the needs of patients with chronic disease conditions. Most physicians, hospitals, practice groups, and health plans have not had the ability to effectively and consistently share patient healthcare information in a systematic or timely manner. Given these factors, the primary challenge facing the health plan was to develop a value-based system for sharing information among insurers, physicians, employers, and patients, and working together to identify meaningful actions that would measurably improve the patient's health outcome. Population Health Quality Improvement Program Improves Outcomes and Reduces Costs Case Study Population Care TM

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