Advanced Plan for Health founder and CEO, Neil Godbey, recently sat down with Benefits Advisors’ reporter, Matt Skoufalos to discuss the state of population health in relation to data management and care management performance. The following is a recap of the interview and the subsequent article.
Skoufalos begins by acknowledging that “As employers work to bridge the gap between healthcare spending and the business value derived from a healthy workforce, many are beginning to ask advisers more about population health management solutions to quantify their approach.”
Dr. Paul Taylor, a CMIO and co-founder of the healthcare company Wellcentive, is quoted saying “Employers spend a lot of money [on health benefits] and it’s not always clear what value they’re getting, or if they’re getting the right care from the right people.”
At this point in the article, a conflict between allocating management solutions into a quantifiable model and the value of health-benefits or the measurable efficiency of “getting the right care from the right people” seems to be at the forefront of the discussion. In essence, we are seeing employers spend large sums of money in hopes of harnessing the undoubted potential of care management combined with data analysis with no truly quantifiable approach. While the approach may be reducing healthcare spend, optimization through the evaluation and re-evaluation of the approach is the management solution. But how does one quantify a management approach into a management solution?
“As a doctor you’re taught to treat people in their illnesses,” Godbey says in the article. “You’re not taught how to see the data and manage people. Doctors continue to treat episodic events. There isn’t a lot of time nor is the reimbursement system geared to managing your patient.”
Mr. Godbey may have the resolution to the aforementioned problem of optimizing the approach into a solution through direct and informed data management. The article goes on to explain that, “Advanced Plan for Health (APH) can actually help predict significant health events among patient populations six to 12 months in advance. By using a blend of data, Poindexter, an APH software engine, can identify neurological, cardiac, or behavioral events, and can help modify patient behaviors to preempt them. The software also is intended to help patients without chronic health conditions participate in wellness programs or copay/premium reductions by staying healthy. Some employers are willing to put their entire deductibles on the line for employees who meet those plan structures.”
Mr. Godbey closes out the article nicely by stating, “the bulk of the shift in value-based care strategies like population health management will also have to come from helping employees view themselves as consumers in a healthcare system with empowering choices rather than patients who are ill and in need of treatment. Since it’s difficult to move the medical profession from treatment philosophy to management philosophy, it’s easier to move the population to a consumer status versus a patient status,” Godbey says. “But that means that benefits and everything else have to come and follow that to encourage them. Most of the structures that are out there are built around making us all patients.”