Population Health Management
Hospital Best Practices and Recommended Strategies
The tools and resources below help leaders and providers transition to value-based systems and prepare for population health management
- Population Health Planning
- Identify and Manage Populations
- Position For Population Health
- Trainings and Examples
Use the Population Health Portal tools to initiate population health planning and navigate next steps toward population health management
- Perform a Population Health Readiness Assessment to determine readiness and evaluate next steps in the planning process
- Apply the Get Informed resources to start collecting data, assessing information and establishing workflow and communication processes
- Learn communication techniques to motivate staff, partners and community to Get Going on initiating the planning process to prepare for population health
- Apply available resources and Put Data To Use to effectively conduct population health analytics with access to a web-based database for acquiring health data specific to your location. This tool consists of educational modules offering step-by-step instructions of common population health analytical procedures. Users can extract data from multiple federal, publicly available datasets to use for population health planning. The portal also provides educational resources about working with the datasets in Microsoft Excel.
- Apply the techniques in the Guide for Rural Hospitals to Identify Populations and Shift to Population Health to identify key patient populations and learn to integrate population health initiatives as part of an organization’s strategy. Providers will gain a greater understanding of how to determine which patient populations to target in their initiatives and where to direct resources to improve quality and outcomes as well as reduce the cost of care.
- Use the self-funded employee health plan to learn how to manage population health interventions
- Use employee claims analysis results to gain experience and build internal analytic capabilities to better understand where opportunities may exist to improve the health of the workforce and improve population health planning and management next steps
- Use Community Health Status Indicators (CHSI 2015) to help identify key populations
- Refer to Guide to Selecting Population Health Management Technologies for Rural Care Delivery to learn how to optimize the health of patient populations. The guide focuses on the patient populations of health care delivery organizations rather than broader community-wide initiatives
- Implement the strategies presented in the 2017 Rural Hospital Value-Based Strategic Summit Guide and Templates (refer to Strategic Planning).
- Participate in programs that add value, such as patient care medical homes, shared savings plans, and Accountable Care Organizations (ACOs) to begin to benefit from available reimbursement options
- Participate in a Patient-Centered Medical Home (PCMH) to position for population health. PCMH structure promotes quality and applies EHR technology to care coordination and aligns primary care providers to increase the value of the organization. It also positions the hospital for per member per month or other payment incentives that some third-party payers have organized for PCMH (refer to Community Care Coordination and Chronic Disease Care Management for detailed information).