Population Health, Value-Based Systems, and Healthcare Opportunities

Posted by Mike Fontana on 29 Oct 2015

Digitized Healthcare: Engaging The New Consumer Patient

Population health is the healthcare and wellness of a given group of people. This group of people can be defined any number of ways—a company’s employees, the employees of a given state, or even a particular hospital’s diabetic patients. However it is defined, the ultimate goal is to keep this group of people healthy, thereby decreasing overall healthcare costs in the long-term.

There is no shortage of compelling reasons for the healthcare industry to implement population health within their organizations. Comprehensive, high-quality care provided by a team of healthcare professionals whose goal is to keep patients informed should generally increase the likelihood of healthy beings. Increasing the quality of care, as well as the overall quality of a population’s health, are goals everyone can agree to.

With population health, however, comes the question of how to deliver quality care within substantive payment models that offer the efficiencies necessary for healthcare providers to remain competitive and profitable. These payment models must also encourage the development of next-generation protocols, processes, and products in order for healthcare providers to keep up with changing trends and demands.

Value-based payment models such as bundled payments and global capitation are also shaking up the healthcare industry. Traditionally, clinics, hospitals, and other healthcare providers were compensated for individual services a patient received. As value-based models become more common, healthcare providers must adapt to flat-fee compensation for a variety of services based on metrics such as overall quality of care or patient ratios. While such models could help increase the efficiency of medical services for consumers, it also increases the amount of risk-based services provided by healthcare professionals.

In light of changing social, economic, and technological trends, healthcare providers must now consider how to approach financial challenges while keeping the best interests of healthcare consumers at the center of the discussion. Providers need to get paid for their services not only so they can continue to serve their communities, but also have capital and cash flow allowing for growth and advances that will push the paradigm forward.

This is where technology-facilitating companies and the financial community come into play. Our roles are critical in supporting healthcare organizations so they are able to adequately support their communities and healthcare consumers. It is our responsibility to ensure that capital access, payment services, and the flow of both capital and information efficiently support healthcare providers. Such services should encompass daily business operation support, as well as provide healthcare organizations the ability to continuously improve the quality of medical care, adapt to industry changes, and make new developments in the space. Without a comprehensive approach, payment reforms are doomed to be a short-term fix.

Our expert industry analysts sense that healthcare organizations are beginning to evolve. A few years ago, healthcare organizations were primarily interested in consolidating relationships for financial benefit. A general perspective on ROI was narrow and focused on short-term gains. Now, the thinking has shifted, and providers are more open to working with organizations small and large. Major players in the healthcare industry are looking to develop relationships with others who have inventive mindsets, flexibility, and nimbleness to help these organizations grow in the long-term.

It is time for financial service providers to think like healthcare consumers in order to understand the challenges facing healthcare clients. Creativity and disruptive thinking will help all parties adjust to the wants and needs of a changing industry. Healthcare, your organization, and the consumer will all be better for it.

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Mike Fontana Healthcare Industry Executive Mike has served in various roles for Consumer Directed Health Care Technology companies. His background also includes Management, Market Development, Consultant, and other roles for healthcare providers, financial institutions, and payers. Mike holds an MBA in Finance from Pace University in New York.

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