About Population Health Management (PHM)
Why change in health care delivery is needed.
In recent years, state and national regulations associated with the Affordable Care Act have encouraged us to think differently about how we deliver care. These new regulations focus on cost containment, specifically keeping health care costs at or below the rate of general inflation. Addressing health care cost growth is important because it’s crowding out spending in other important areas.
In response to these regulations, Partners HealthCare has shifted away from fee-for-service payments and entered into alternative payment systems where providers agree to a total medical expense (TME) spending target for an assigned population of patients. If spending remains below target, we are rewarded with “shared savings” payments. If we exceed the target we are penalized. We are also measured on our performance on quality and patient experience.
Prior to these regulations, we were deploying new models of care to reduce the growth of health care costs and improve care, but this new contracting environment has accelerated our efforts. Population Health Management (PHM) is the name we have given to our strategy for fulfilling our commitment to improving care and reducing health care costs.
So what exactly is Population Health Management?
Population Health Management is a collection of activities, not reimbursable in the fee-for-service model, but important in the care we deliver to our patients. We provide the resources and technology for our hospitals and community clinics to implement PHM across all phases of care and have organized our activities into five key areas outlined below.
- Primary Care: Supporting primary care practices in practice redesign (patient-centered medical home) and coordination of care for patients with complex care needs (integrated Care Management Program)
- Specialty Care: Improving care coordination between Primary Care and Specialty practices and enhancing access to specialty services
- Non-Hospital Care: Providing home-based care for patients with acute illness and developing services to better manage transitions of care (among nursing facilities, hospital, and home)
- Patient Engagement: Offering providers and patients tools to improve communication, education, and patient self-care
- Analytics and Technology: Creating a single, centralized electronic health record with decision-support tools and a data warehouse for analytics and performance reporting
Our PHM Team is dedicated to realizing effective and efficient care.Meet the Team