Tag Archives: MD

Humana Bold Goal Launched in Jacksonville, Florida – a Call to Action

This is the longer original piece with all the links and images that  was the genesis for the Florida Times Union commentary.

This past month I had the opportunity to participate during Humana’s  half-day Bold Goal launch conference in Jacksonville, Florida (the county seat is Jacksonville and there has been a consolidated government of Duval County since 1968, so some refer to the broader county).  The conference had excellent presentations and I was honored to be included with a distinguished group of panelists from the Health Department, hospitals, providers of care and the Duval County Medical Society. It was nice to be involved in an event and try to play a role in improving the health in the community in which I live.

There are other efforts ongoing to improve community health in Jacksonville, including the Clinton Health Matters Initiative, which has focused on solving the hunger issues and a number of hospitals have launched their own efforts as part of the Community Health Assessment and Improvement Plan. While these programs and others in the community may have made some progress, Jacksonville still faces major health issues and our quality measures are poor:

Some of the major barriers we face include:

  • we tend to say we need more data or another study,
  • we have not been very innovative, and
  • we have little accountability.

As far as data goes, there are plenty of studies available in addition to those cited above. Here are just a few more interesting ones: Continue reading

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Is Population Health Management Just Clinical??

A while back I saw this Quote in the Population Health Bulletin of the Population Health News

“Population health management is founded on understanding population and subgroups’ clinical needs and utilization patterns and by being informed by tools and tactics to predict future risks and utilization. These are exactly the strategies we need to successfully reduce readmissions: Know your data and why your patients are readmitted; identify readmission risk factors, broadly defined; address and mitigate those risks; and ensure successful linkage to follow up and services in the community. Readmission reduction is a training ground for population health management capabilities.”
-Amy E. Boutwell, M.D., MPP, President, Collaborative Healthcare Strategies

Population health management provides a very good approach to  target and reduce readmissions and many other healthcare utilization, quality and cost issues.  While this quote starts out by  stating that “Population Health Management is  founded on understanding populations and subgroups’ clinical needs and utilization patterns”  it deftly moves to “identify risk factors, broadly defined; address and mitigate those risks; and ensure successful linkage to follow up services in the communities

The reason for a readmission may be due to non-clinical issues such as the community they returned to and their sociodemographic situation.

Its clear  that the foundation for population health should include broader factors such as sociological determinants of health in addition to “clinical needs and utilization patterns” on the front end, but by stating “broadly looking at risks”, I assume this means looking beyond current clinical risk or utilization, and getting the community linkages, which are certainly required as part of the program to reduce readmissions.

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