Web2pro spoke with Rose Higgins, senior vice president and general manager of population and risk management at Web2pro, about the resources that healthcare providers need to create and manage a successful population health management strategy. Higgins talks about the people, talent, skill set and management required to excel at population health.
What job titles or functions should fall under population health management?
Higgins: There are three what I like to call “boots on the ground” jobs to be done for population health.
- Data analysts: These are the people who have an appreciation and understanding of data. They need to know how to collect it, analyze it and leverage it.
- Care managers: These are the people who can take that data and understand the health needs of a population, and then act on it. These are typically new or novel positions for provider healthcare organizations taking on population health management.
- Care coordinators or navigators: These are the people who make sure that things get done and everyone on the care management team is on the same page.
What about at the management or c-suite level?
Higgins: At provider healthcare organizations taking population health management seriously, we’re starting to see new positions and titles such as chief of population health, chief quality officer, chief transformation officer and chief integration officer. These are the folks who are really looking at doing the business of healthcare differently and being responsible for the outcome.
Where should population health management fall on a provider’s organizational chart?
Higgins: At many hospitals and health systems, it would fall directly under that new C-suite level position. At others, it would be a more traditional reporting line up to the chief medical officer. Either way, it’s now typical for a c-suite level position to have the responsibility for making sure that a healthcare organization’s population health strategy is effective.
What would be the optimum size of a population health management department?
Higgins: We call that “caseload ratio.” Caseload ratio depends on the size of the population you’re managing and the risk profile of that population. It also depends on what you’re trying to do with which part of your population. If you’re targeting high-risk patients with aggressive care management plans, you’re looking at a caseload ratio of 1 to 25 or 1 to 50, or one person for every 25 or 50 patients. For moderate-risk patients with less intensive care management, it’s 1 to 250. For low-risk patients with basic prevention and wellness strategies, it’s 1 to 5,000. Most healthcare organizations are targeting high- and moderate-risk patients with their population health programs, or about 100 to 300 patients, which translates into four to six additional positions.
What’s the cost in terms of head count?
Higgins: Those senior positions are quite costly but important nonetheless, and the boots-on-the-ground people will be $100,000 to $150,000 each, including salary and benefits. Plan to spend accordingly.
How will a healthcare organization know if it’s worth it? What’s the ROI on population health?
Higgins: The first step is setting a reasonable expectation for a one-year return and for a long-term return. Remember, the goal is improving a population’s health status and reducing their life-time cost of using the healthcare system. You measure ROI by reductions in key utilization measures like hospital admissions, hospital days, readmissions, emergency department visits, and then attaching a dollar figure to those measures. It’s not unreasonable to expect double-digit reductions in each of those measures with cost savings running into the millions of dollars in just one year. An effective population management strategy will support all manner of value-based programs, ACOs included. The potential ROI of an effective population health management program is tremendous and well worth the expense of setting one up and doing it the right way.