What Is Population Health Management?
Population health management is a comprehensive approach to improving health outcomes and reducing the costs of a defined patient population. It involves using data and technology to identify high-risk patients, engage them in care, and coordinate services across the healthcare continuum.
How to Get Started with a Population Health Management Program
Getting started with a population health management program can seem overwhelming, but with the right partner, it can be a smooth and efficient process. Here are a few steps to help you get started:
- Identify your target population
- Assess the current state of health and risk
- Develop a comprehensive care plan
- Engage patients in care
- Implement data-driven interventions
- Monitor progress and outcomes
What drives your health care costs?
Improving the health of your employees and then finding ways to reduce existing health care costs are the biggest things you can do to impact your health care expenses. Our team of experienced professionals is here to help you do exactly that. We are focused on flattening the ever increasing health care curve. Population health will give you the data and strategy you need to manage your health care costs.
Benefits of Population Health Management
Your employees are your most valuable resource. That’s why we have a team of experts to help you improve their overall health and wellbeing, identify areas of concern, and make sure they get appropriate care – all while managing costs. There are numerous benefits of population health management, including:
- Improved health outcomes
- Reduced healthcare costs
- Increased patient engagement
- Better coordination of care
- Improved quality of care
How Can Providers Get Started With Population Health Management?
To get started with population health management, providers need to have a solid understanding of their target population and the current state of health and risk. They should also have a comprehensive care plan in place, engage patients in care, implement data-driven interventions, and monitor progress and outcomes.
Analytics & Predictive Modeling
Data Driven Intervention
In-House Expert Review
What is the Main Goal of Population Health Management Programs?
The main goal of population health management programs is to improve health outcomes and reduce the costs of a defined patient population. This is achieved through a range of strategies, including:
Chronic Disease Management
Chronic disease management is a critical component of population health management. By managing the health of patients with chronic conditions, healthcare providers can improve outcomes and reduce costs.
Wellness and Preventive Health
Wellness and preventive health are important parts of population health management. By engaging patients in preventive care, healthcare providers can help prevent chronic conditions and improve health outcomes.
Clinically Integrated Networks
Clinically integrated networks are a key component of population health management. By coordinating care across the healthcare continuum, healthcare providers can improve outcomes and reduce costs.
Patient-Centered Medical Home (PCMH)
A Patient-Centered Medical Home (PCMH) is a model of care that emphasizes the relationship between a patient and their primary care provider. The goal of the PCMH model is to provide coordinated, comprehensive, and accessible care to patients, which leads to improved health outcomes, higher patient satisfaction, and reduced healthcare costs.
At-Risk Payment Structures
At-risk payment structures are a type of payment system used in healthcare that incentivizes providers to focus on quality, cost-effective care. In an at-risk payment structure, providers are paid based on the outcome of the care they provide, rather than the volume of services they perform.
At-Risk Cost Structures
At-risk cost structures are similar to at-risk payment structures in that they incentivize providers to focus on quality, cost-effective care. However, in an at-risk cost structure, providers bear some of the financial risks for the care they provide. This type of cost structure can encourage providers to be more proactive and cost-conscious in their approach to patient care, which can lead to improved health outcomes and lower healthcare costs.
What Is Population Health Management?
How to Get Started with a Population Health Management Program
Getting started with a population health management program can seem overwhelming, but with the right partner, it can be a smooth and efficient process. Here are a few steps to help you get started:
- Identify your target population
- Assess the current state of health and risk
- Develop a comprehensive care plan
- Engage patients in care
- Implement data-driven interventions
- Monitor progress and outcomes
What drives your health care costs?
Improving the health of your employees and then finding ways to reduce existing health care costs are the biggest things you can do to impact your health care expenses. Our team of experienced professionals is here to help you do exactly that. We are focused on flattening the ever increasing health care curve. Population health will give you the data and strategy you need to manage your health care costs.
Benefits of Population Health Management
Your employees are your most valuable resource. That’s why we have a team of experts to help you improve their overall health and wellbeing, identify areas of concern, and make sure they get appropriate care – all while managing costs. There are numerous benefits of population health management, including:
- Improved health outcomes
- Reduced healthcare costs
- Increased patient engagement
- Better coordination of care
- Improved quality of care
How Can Providers Get Started With Population Health Management?
To get started with population health management, providers need to have a solid understanding of their target population and the current state of health and risk. They should also have a comprehensive care plan in place, engage patients in care, implement data-driven interventions, and monitor progress and outcomes.
Analytics & Predictive Modeling
Data Driven Intervention
In-House Expert Review
What is the Main Goal of Population Health Management Programs?
The main goal of population health management programs is to improve health outcomes and reduce the costs of a defined patient population. This is achieved through a range of strategies, including:
Chronic Disease Management
Chronic disease management is a critical component of population health management. By managing the health of patients with chronic conditions, healthcare providers can improve outcomes and reduce costs.
Wellness and Preventive Health
Wellness and preventive health are important parts of population health management. By engaging patients in preventive care, healthcare providers can help prevent chronic conditions and improve health outcomes.
Clinically Integrated Networks
Clinically integrated networks are a key component of population health management. By coordinating care across the healthcare continuum, healthcare providers can improve outcomes and reduce costs.
Patient-Centered Medical Home (PCMH)
A Patient-Centered Medical Home (PCMH) is a model of care that emphasizes the relationship between a patient and their primary care provider. The goal of the PCMH model is to provide coordinated, comprehensive, and accessible care to patients, which leads to improved health outcomes, higher patient satisfaction, and reduced healthcare costs.
At-Risk Payment Structures
At-risk payment structures are a type of payment system used in healthcare that incentivizes providers to focus on quality, cost-effective care. In an at-risk payment structure, providers are paid based on the outcome of the care they provide, rather than the volume of services they perform.
At-Risk Cost Structures
At-risk cost structures are similar to at-risk payment structures in that they incentivize providers to focus on quality, cost-effective care. However, in an at-risk cost structure, providers bear some of the financial risks for the care they provide. This type of cost structure can encourage providers to be more proactive and cost-conscious in their approach to patient care, which can lead to improved health outcomes and lower healthcare costs.
Population Health Management Strategies
Population Health Management Strategies
Analytics & Predictive Modeling
- Integrate Medical, Pharmacy, Biometric and Health Risk Assessment data
- Track Disease Burdens, Gaps in Care, and Utilization Metrics
- Identify Opportunities through Risk Scoring Algorithms
Data Driven Intervention
- Confirm diagnosis and appropriateness of drug/treatment
- Discuss shifts in care to cost effective locations
- Support with tools and program strategies to engage members
In-House Expert Review
- Actuarial - Full time staff
- Clinical - Full time staff
- Wellness - Full time staff
Analytics & Predictive Modeling
- Integrate Medical, Pharmacy, Biometric and Health Risk Assessment data
- Track Disease Burdens, Gaps in Care, and Utilization Metrics
- Identify Opportunities through Risk Scoring Algorithms
Data Driven Intervention
- Confirm diagnosis and appropriateness of drug/treatment
- Discuss shifts in care to cost effective locations
- Support with tools and program strategies to engage members
In-House Expert Review
- Actuarial - Full time staff
- Clinical - Full time staff
- Wellness - Full time staff
rory housley, FSA
VP Population Health
Advanced Analytics
Advanced Analytics
We feature a powerful data platform that collects claims data, but we don’t stop there. Our Advanced Analytics team takes our clients’ data from confusing numbers to actionable information. It’s all about recognizing trends, identifying areas of concern, and making decisions using our expertise and proprietary reporting.
We feature a powerful data platform that collects claims data, but we don’t stop there. Our Advanced Analytics team takes our clients’ data from confusing numbers to actionable information. It’s all about recognizing trends, identifying areas of concern, and making decisions using our expertise and proprietary reporting.
Data Warehousing, Reporting, and Analysis
Plan performance relative to premiums/funding, High Cost Claimant Summaries including prospective risk based on prior claims, Ad-hoc analysis.
Underwriting Projections for Premiums/Funding Rates
Use rating methodologies specific to carriers and funding type, Support consultants in rate negotiation with carriers, Calculate expected costs and maximum liabilities with stop- loss coverage (self-funded), Estimate claims that have been incurred-but-not-reported (self-funded).
Plan Design and Contributions
Incorporate plan decrements and contribution changes to premiums/funding rates, Illustrate plan design and contribution structures from member perspective.
DATA WAREHOUSING, REPORTING, AND ANALYSIS
Plan performance relative to premiums/funding, High Cost Claimant Summaries including prospective risk based on prior claims, Ad-hoc analysis.
Underwriting Projections for Premiums/Funding Rates
Use rating methodologies specific to carriers and funding type, Support consultants in rate negotiation with carriers, Calculate expected costs and maximum liabilities with stop- loss coverage (self-funded), Estimate claims that have been incurred-but-not-reported (self-funded).
Plan Design and Contributions
Incorporate plan decrements and contribution changes to premiums/funding rates, Illustrate plan design and contribution structures from member perspective.
Medical Advisory Services
Medical Advisory Services
We put a Medical Director in your corner, maximizing your benefit offerings and the health of your employees. They act as a watchdog, reviewing high cost claimants and those with complex cases to oversee care management and make certain that only the best practices and treatment are being administered.
We put a Medical Director in your corner, maximizing your benefit offerings and the health of your employees. They act as a watchdog, reviewing high cost claimants and those with complex cases to oversee care management and make certain that only the best practices and treatment are being administered.
Russell Vinik, MD
Medical Director
Clinical Insight
Review high cost claimants, Works with carriers, Looking for duplicate payments, excessive charges, claims outliers, people who need care management, abuse, Make recommendations on coverage, Recommend wellness initiatives and education.
Cost Savings
Negotiate stop loss rates, remove lasers, Provide insight for future cost and benefit usage, Advocate for better contracts, Enhance care management, Utilization, transparency, appropriateness of treatment, Liaison with health plan.
Clinical Insight
Review high cost claimants, Works with carriers, Looking for duplicate payments, excessive charges, claims outliers, people who need care management, abuse, Make recommendations on coverage, Recommend wellness initiatives and education.
Cost Savings
Negotiate stop loss rates, remove lasers, Provide insight for future cost and benefit usage, Advocate for better contracts, Enhance care management, Utilization, transparency, appropriateness of treatment, Liaison with health plan.
Joe Tooley, pharmD, MBA
Pharmacist
Pharmacy
Pharmacy
Did you know that pharmaceutical benefits are some of the most widely used? This can have a significant impact on your healthcare costs. Fortunately, GBS has the prescription. Our full-time pharmacist is here to reduce your spending and improve your coverage.
Did you know that pharmaceutical benefits are some of the most widely used? This can have a significant impact on your healthcare costs. Fortunately, GBS has the prescription. Our full-time pharmacist is here to reduce your spending and improve your coverage.
Pharmacy Benefit Consulting
- Pharmacy Benefit Performance Evaluation, RFP/Procurement
- Benchmarking, Optimize Plan Performance, Trend Management Solutions, Benefit Strategy
Clinical Services + Population Health
- Comprehensive Medication Reviews, Utilization Management, Population Health Team Support & Insight
Client Suppor
- Ongoing Support and Management of GBS & Client Team, Analytics & Reporting
- Pharmacy Benefit Performance Evaluation, RFP/Procurement
- Benchmarking, Optimize Plan Performance, Trend Management Solutions, Benefit Strategy
Clinical Services + Population Health
- Comprehensive Medication Reviews, Utilization Management, Population Health Team Support & Insight
Client Support
- Ongoing Support and Management of GBS & Client Team, Analytics & Reporting
“The new offering via the Canadian Specialty Rx program has also been greatly received from the few folks I have spoken with here at Copper. In combination with them being on a HDHP, the benefit of free medications has been a huge win for the employee.”
– Suzanne Snell, Copper Mountain Resort
Health & Wellness Consulting
Health & Wellness Consulting
Employers are not one-size-fits-all, so neither should your wellness program. With the right program in place, worksite wellness has been shown to increase productivity, enhance morale and lower costs. Let our highly trained team carefully design a program with your unique employees and objectives in mind.
Employers are not one-size-fits-all, so neither should your wellness program. With the right program in place, worksite wellness has been shown to increase productivity, enhance morale and lower costs. Let our highly trained team carefully design a program with your unique employees and objectives in mind.
becca rick, MS, RD
Director Wellness
Assess Client Needs & Interests:
- Workplace Cultural Audit, Employee Interest Survey, Senior Level Support
Implement a Wellness Culture:
- Wellness Committee, Short and long-term goals, Communication Strategy, Resources, Incentive structure
Develop a Structured Wellness Program:
- Carrier, Community and Wellness Program, Administrators, Health Screenings and Assessments, Wellness Interventions
Evaluate Program Outcomes:
- Population Health Management, Outcomes-Based Program, Coordination of care
ASSESS CLIENT NEEDS & INTERESTS:
- Workplace Cultural Audit, Employee Interest Survey, Senior Level Support.
IMPLEMENT A WELLNESS CULTURE:
- Wellness Committee, Short and long-term goals, Communication Strategy, Resources, Incentive structure.
Develop a Structured Wellness Program:
- Carrier, Community and Wellness Program, Administrators, Health Screenings and Assessments, Wellness Interventions.
Evaluate Program Outcomes:
- Population Health Management, Outcomes-Based Program, Coordination of care.
Get a FREE 30 minute benefit consultation with an expert
- How to lower your overall health care costs
- How to make sure you are compliant with current HR laws and regulations
- Implementing a wellness program in your company
- Streamlining your enrollment process
Get a FREE 30 minute benefit consultation with an expert
- How to lower your overall health care costs
- How to make sure you are compliant with current HR laws and regulations
- Implementing a wellness program in your company
- Streamlining your enrollment process
