The Population Health Colloquium: Social Determinants of Health, Precision Medicine and the Triple Aim

By Fred Goldstein, MS and Gregg Masters, MPH*

The field of population health continues to grow and create new areas of exploration and integration. Population health practitioners are called upon to play a central role as health systems, health plans or healthcare organizations work to implement their strategies designed to improve health care quality, access, outcomes and cost while weaning the US Healthcare system away from its fee-for-service reimbursement paradigm.

From the emerging recognition that Precision Medicine is not antithetical to population health, to the development of unique approaches to address the social determinants of health, it’s an exciting time.

This year’s agenda for the Population Health Colloquium reflects the dynamic nature of the field, featuring leading healthcare experts from academia, healthcare systems, health plans, data and analytics companies, population health companies, regulators, innovators and entrepreneurs. To add to the excitement, the $100,000 Hearst Health Prize will be awarded to one of three deserving finalists: the University of Arkansas Arkansas SAVES program; the Mental Health Outreach for Mothers (MOMS) Program; and the Sharp Transitions Program.

A range of value-based care and alternative payment models are being implemented across the U.S. healthcare landscape, and will be covered in depth at the Colloquium with presentations on ‘Are Alternative Payment Models Working?’ presented by Lawton R. Burns, PhD, MBADirector of the Wharton Center for Healthcare Management and Economics and the James Joo-Jin Kim Professor of Health Care ManagementWharton School, University of Pennsylvania, and François de Brantes, MBA, Senior Vice President of Commercial Business DevelopmentRemedy Partners. There will also be a number of ‘mini-summits‘ addressing value-based care and alternative payment models in different contexts and settings (orthopedic bundle, collaborative care, chronic conditions, patient engagement, and elder care).

The move to alternative sites of care will be covered in ‘Evolving Care Outside the Hospital to Meet Consumers Where They Are’, presented by Niki Buchanan, MA, PHMGeneral Manager, Philips PHM, and Shauna CoyneDirector of InnovationsNew York-Presbyterian Hospital.

A Special Dinner Program (Tuesday, March 19), download brochure here.

Cells Are the New Cure: Advances in Precision Medicine‘ will focus on innovations, science, technology and medicine and explore the advances in precision medicine that are providing pathways to cures using human cells. The Panel will include, Richard M. Cohen JournalistNews Producer, “Dr. Max” Gomez, PhD, an Emmy-Award Winning Medical Correspondent, Robin L. Smith, MD, MBAPresident and ChairmanCura Foundation, and Meredith VieiraEmmy Award-winning TV JournalistHost, Executive Producer and Anchor.  Attendees at this event will each receive a copy of ‘Cells are the New Cure’ by Robin Smith, MD, MBA and “Dr. Max” Gomez, PhD and ‘Chasing Hope’ by Richard M. Cohen.

Join us on PopHealth Week, Wednesday, March 6th, as we chat with co-authors Max Gomez, PhD, and Robin L. Smith, MD, MBA to preview the principal message featured in their book including implications for population health management.

A major focus of the final day will be looking at the healthcare system itself, discussing what’s wrong and how we (including healthcare consumers) can fix it. Presentations will be given by Robert Pearl, MDContributor, ForbesProfessorStanford University School of Medicine, author of ‘Mistreated: Why We Think We’re Getting Good Health Care — and Why We’re Usually WrongElisabeth Rosenthal, MDEditor-in-ChiefKaiser Health News, author of ‘An American Sickness: How Healthcare Became Big Business and How You Can Take It Back and Archelle Georgiou, MDPresidentGeorgiou ConsultingAuthor and Consumer Advocate, author of ‘Healthcare Choices: 5 Steps to Getting the Medical Care You Want and Need.

To conclude the Colloquium, the ever popular Health Leaders Panel will be moderated by Dr. Nash. This year’s line-up includes Mandy Mangat, MD, MPHChief Medical OfficerNavvis HealthcareDavid Nace, MDChief Medical Officer, InnovaccerRita Numerof, PhDPresidentNumerof & Associates, Inc.; and Gary A. Puckrein, PhDPresident and Chief Executive Officer of the National Minority Quality Forum.

And that’s only a peek at some of the timely presentations, panels and mini-summits at this year’s Colloquium. If you haven’t registered yet, (more information here), there’s still time to block your schedule, secure your travel arrangements and come to the best Population Health Conference of the year,  March 18-20th at the Loews Philadelphia Hotel, in the City of Brotherly Love.

Still on the fence?, check out this invitation to the Colloquium via David B. Nash, MD, MBADeanJefferson College of Population Health, and our last chat with Dr. Nash, in ‘Accelerating toward “Value Based Care”…or, “No Outcome, No Income”.’

We hope to see you there!

* Post sponsored by the Jefferson College of Population Health

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A Frustrating Day at a Community Health Improvement Program

A few months ago, I attended a community health annual event associated with one of the many initiatives started by a large organization to bring together groups and begin implementing programs to improve the health of the community.

 

At this particular event after a couple of years of meetings and work, there were a number of presentations by the organization, community groups, the local government and a review of work done to date. It was a Kumbaya moment. Near the end of the day when people were asking questions, a gentleman next to me stood up, he worked in one of the poorest neighborhoods in the city and oversaw a local effort in that community.

He said and I’m paraphrasing.

 

I look at our community and see it has the exact same issues today we had 50 years ago. Nothing has changed, nothing has been done and we look just the same. You tell us to exercise but we have no sidewalks, no parks, the nearest gym is 3 miles away, we have no transportation, no access to healthy foods…

and well you know the rest of the issues he raised. He was clearly frustrated and has every right to be.

At that point a young woman stood up, she runs a yoga program that is one of the initiatives this group has been promoting and touting as a mental health solution for the community. She responded, again I’m paraphrasing:

We’d be happy to come to your community, don’t worry about transportation we will come to any building, any location, we can train some trainers, we’ll need to get some funding, but we can bring the services to you, you don’t need to come to us. 

She was adamant that she had a solution for this gentleman and his community, while he just quietly sat there listening as she went on and on and on.

So, let’s just cut to the chase. Who really believes that in the top 50 needs of this community, Yoga would be one?

It’s yet another example of people who are not part of the community:

1)   Thinking they know what’s right.

2)   Selecting some apparently cool idea that they would like for themselves for someone else.

3)   Not asking the community what they need and want before starting.

4)   Doing something to check the “I did something box” but not really doing anything meaningful.

5) Selecting a project that will be difficult to scale, that will ultimately impact a small group of people (those who like yoga).

There has got to be a way to get some funds to this community and put in a sidewalk, fix up a park, locate a grocery store, create some safety, improve the schools. At the same time, that this community was (and still is) in need of these basic improvements, the city funded a major road development in another part of town adding bike lanes. Of course, the safety of cyclists is an issue, but this was done in the wealthier part of town. Did their need outweigh the more basic needs this community has?

How do we not get caught up in this approach, which happens more frequently than we’d like?

1)   Ask the community what they need. They know and are more than willing to share. In fact I’m sure most of the people in this community and members of this group know as well; perhaps they just think those issues are not solvable, are too heavy a lift, beyond their scope, who knows? So

2)   Focus on the communities needs like a laser until you find a solution. It may not be in your wheelhouse, may take some time, but with enough focus and the bringing together of the right people solutions can be found.

3) Don’t be afraid to call out stuff thats not working. It’s not a negative. If what you’re doing doesn’t solve the problem, do something else.

4) Look at other funding in your community and move some of that. We all face limited resources. Groups like this need to be a voice for those who are not being heard when decisions are made on funding.

5) Eat the elephant one bite at a time. Perhaps start with fixing one street, part of a park, but all the while think big, think scalable, think of the end results, and incrementally make it better.

To put a nice bow on their approach,  I asked before the meeting if I could discuss H.R. 660, the Community Health Improvement and Leadership Development (CHILD ) Act that we have before Congress (with Bipartisan support) at the event and was told,

No that they did not want to get into Politics. The CHILD ACT would put the funds into the hands of the community themselves overseen by a local board to select their own projects and fund them up. I guess that’s antithetical to their approach in more ways than one.

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The Validation Institute – How they can Assist Employers

The vast majority of employers are continuing to experience rising health insurance costs. We know there are areas of healthcare from quality differences to the variation in utilization that can negatively impact an employer health plan and its estimated that 30% of healthcare is unnecessary, waste and/or fraud. To solve this there have been many solutions proposed including wellness, imaging management, PBMs, High Deductible Health Plans, Direct Primary Care, Value Based Care, direct contracting and many, many others. In each of these solutions there is typically some sound belief that the concept will work, but there are also a lot of vendors or healthcare providers out there claiming they have the answer and this is often filtered through a broker who may or may not have your best interest at heart (Read about some the egregious behavior here “Insurers Hand Out Cash and Gifts To Sway Brokers Who Sell Employer Health Plans“).

So how can one identify providers of services who can achieve results? Well that’s where the Validation Institute comes in. To get a sense of the why and what the Validation Institute can do for you, watch this short video:

 
 

For full disclosure I was involved early with this group and since then have assisted in various capacities. I currently serve as a Senior Advisor, Standards and Compliance and also serve as a Judge for the Health Value Awards which are given annually at the World Health Care Congress to companies, employers and brokers who can show that they demonstrably improve the outcomes for their employees and lower costs. The validated Health Value Awards are also reviewed by the Validation Institute.

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An Interview with Kaveh Safavi at HIMSS

Every year at HIMSS, Gregg Masters and I get a chance to sit down with Kaveh Safavi, MD Senior Managing Director, Head of the Global Healthcare Practice at Accenture. It’s become one of the meetings we most look forward to.  This year Kaveh discussed Accenture’s recently released Digital Health Consumer Survey and he also discussed a little bit about his thoughts on AI that he shared in a recent piece in Forbes.

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Presentation on Population Health at the Leading Healthcare Organizations Conference in Kuwait

Looking forward to presenting on Population Heath and conducting a workshop on Developing a Population Health Management Program for persons with Diabetes at this years Leading Healthcare Organizations Conference February 3 and 4th in Kuwait City, Kuwait.

Here is a link to the brochure.

vigor title page

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