Population Health An Implementation Guide to Improve Outcomes and Lower Costs 1st Edition by George Mayzell ISBN 1498705553 9781498705554

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Product details:

ISBN 10: 1498705553 
ISBN 13: 9781498705554
Author: George Mayzell

Population Health An Implementation Guide to Improve Outcomes and Lower Costs 1st Table of contents:

1 What Is Population Health?

• U.S. International Ranking

• Population Health versus Public Health

• Definition of Population Health

  • Definition One

  • Definition Two

  • Definition Three

• Health versus Healthcare Delivery

• Building a Population Health Model

• Bibliography

2 Why Population Health Now?

• CDC Works Out Morbidity and Mortality Weekly

• Rising Healthcare Costs

• Financial Drivers

• Just Managing the “Sick” Doesn’t Work

• Changing from Volume to Value

• Six Separate Components of This Transition

• Six Requirements to Change to Value-Based Care

• Employers’ Care

• Engagement of the Payers

• It Is Really Different This Time?

• Migration to Population Health

• Final Word

• Bibliography

3 The Care Continuum

• Acute Inpatient Care

• Education and Practice Implications

• Acute Care in the Current World

• The Post-Acute Care Continuum

• Independent Living Villages

• Assisted Living

• Short-Term Skilled Rehabilitative Services

• Traditional Long-Term Care Skilled Services

• Dementia Care Units

• Palliative Care

• Hospice Care

• Home Care Services

• Patient-Centered Medical Home and the Medical Neighborhood

• Family

• Federally Qualified Health Clinics

• Community Agencies

• Employers

• Conclusion

• Bibliography

4 Managing Population

• Introduction

• Choosing the Population

• Risk Stratification

• Risk Stratification Performance

• Predictive Analytics

• Care Models That Account for Risk

• Care Management Programs and the Patient-Centered Medical Home

• Ambulatory Care-Sensitive Conditions

• Summary

• Bibliography

5 Patient-Centered Medical Home and Its Brethren: New Care Delivery Models

• Traditional Primary Care

• Patient-Centered Medical Home

• The Medical Neighborhood

• Conclusion

• Bibliography

6 The Value Proposition for Prevention and Screening

• What Constitutes “Prevention”?

• Who Is Responsible for Prevention?

• Determining the Costs and Benefits of Prevention

• Prioritizing Prevention Activities: Getting the “Biggest Bang for the Healthcare Buck”

• Will Increased Focus on Prevention Decrease Healthcare Costs? Does It Matter?

• Conclusion

• Bibliography

7 Big Data Enables Population

• What Is So Great about Big Data?

• Four Vs of Big Data

• Data Sources

• Why Big Data Is Hard to Achieve

• Industry Preparedness

• Data Reliability

• Environmental Concerns

• Cultural Impediments

• Big Data Impact on Population Health

• Source Determination

• Acquisition

• Processing

• Organization

• Segmentation

• Prediction

• Application to the Triple Aim

  • Improving Population Health

  • Enhancing Experience of Care

  • Reducing Per Capita Cost

• Where Will Big Data Take Us?

• Big Data Leverages New Technology

• What Are the Implications?

• Bibliography

8 Managed Care and Payer Models

• Payment Models

• The Financial Drivers

• Population Health

• Bibliography

9 Physician Compensation Models

• Traditional Physician Compensation Models

• Guaranteed Salary

• Productivity Models

• Productivity Measures

• Quality Programs, Metrics, and Measures

• Patient-Centered Medical Homes

• CMS Medicare Value-Based Initiatives

• Meaningful Use

• Physician Quality Reporting System

• Value-Based Payment Modifier

• Value-Based Reimbursement

• Care Management Programs

• Case Rates and Bundled Payments

• Shared Savings, Full Risk, and Accountable Care Organizations

• Effect on Physician Compensation Models

• The Need for and Elements of Change

• Selection of Specific Quality Metrics: Access

• Disease-Specific Care Management Guidelines

• Outcomes and Results

• Patient Experience

• Cost Efficiency and Utilization

• Examples of Weighting and Structure of Potential Compensation Models

• Special Issues to Consider

• Metrics for Specialty Physicians

• Accommodation for Physicians Nearing Retirement or with In-Demand Subspecialty Skills

• Incentives for Nonphysician Providers

• Rewards for Leadership and Citizenship

• Compensation Models and Formulas: The Only Constant Is Change

• Bibliography

10 Technology and Decision Support

• EHRs, HIEs, and Federal Repositories: How Are EMRs, HIEs, and Federal and State Data Repositories Aiding in the Improvement of Population Health?

  • Past

  • Present

  • Future

• Middleware/Connection Technologies: How Is Middleware Being Used to Facilitate the Exchange of Information and Improve Interoperability between Different Systems? Is Middleware a Midterm Solution?

• Consumerism Applications: How Will the Information Gathered Aid Patients in Staying Healthy and Accessing Care, and Physicians in Diagnosing Illnesses and Improving Consumer Satisfaction?

• Technology in the Home: What Are the Wellness, Remote Monitoring, Diagnoses, and Treatment Devices That Can Be Used in the Home?

  • Wearable Devices

  • Smartphone Apps

  • Hand-Held Devices

  • Remote Monitoring/Coaching/Education

  • Telehealth Services

• Bibliography

11 Patient Engagement

• Consumerism

• Attribution

• Patient Engagement

• Theories of Behavior Change

• Physician Relationship and Influence

• Payer and Health Plan Models

• Employer Models

• Employer Programs

• Public Health and Public Policy

• Bibliography

12 Population Health, Healthcare Disparities, and Policy

• Systems of Health versus Healthcare Systems

• Primary, Secondary, and Tertiary Prevention

• Healthcare Systems

• Systems of Health

• The Social Determinants of Health

• Genetic, Diagnosis, Zip, and Payer Codes

• Population Health versus Health of Populations

  • Population Health

  • Health of Populations/Community Health

• What’s Needed for Effective Population Health Management?

• Healthy People 2020 and the Definition of Disparity

• Social Determinants

• Geographic Units of Analysis

• Breast Cancer as a Case Study in Disparity

• Environmental and Socioeconomic Factors

• Food Deserts

• Physical Activity Deserts

• Pollution

• Socioeconomic

• Ethics

• Health Equity

• Cost

• Cost–Benefit or Effectiveness

• Conclusion

• Bibliography

13 Case Studies

• Case Study One: Adventist Health Network Begins Transition from Volume to Value

  • Decision to Transition to Value

  • Available Options

  • Building Framework and Resources

  • Status and Opportunities

• Case Study Two: One ACO’s Journey to Comprehensive, Connected, Continuous Care

  • Leadership

  • Building on What Was Already There

  • Covered Lives

  • Shared Savings

  • Challenges Overcome

• Case Study Three: Launching Population Health Program in 12 Months

  • Infrastructure Development (the “Product”)

  • Provider Network (“Distribution System”)

  • Acquiring Patients to Manage (“Customers”)

• Case Study Four: An Interprofessional Approach to Improving Care Coordination: The Transition Clinic at Rush University Medical Center

  • Background

  • Case

  • Conclusion

• Case Study Five: Cigna Collaborative Care

• Case Study Six: Patient-Centered Medical Home (PCMH)

  • Rush Health

• Bibliography

14 The Future of Healthcare Delivery

• In a Three- to Five-Year Timeframe

• In the Five- to Ten-Year Timeframe

• Summary

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Tags: George Mayzell, Population Health, Lower Costs