As ubiquitous as population health is across the industry, variation and uncertainty persists. Industry literature is filled with numerous population health management models from academia, government, and vendors. Population health management programs are as varied as the populations they serve. There is little agreement on definitions or alignment with specific payment arrangements and populations. Stakeholders groups engaging in population health management are seeking answers as they develop their population health strategies:
- Providers: “What capabilities do I need to develop/acquire as I’m engaging in value-based contracts?”
- Vendors: “What capabilities are important for stakeholders engaged in value-based contracting so I can prioritize feature development?”
- Payers: “How can I assess the readiness of providers in my network to engage in value-based contracting?”
- Government: “What policies do I need to develop to facilitate adoption of value-based reimbursement?”
- Trade organizations: “What tools/programs do we need to develop to support our members?”
To help bring clarity to your population health efforts, the HIMSS Clinical & Business Intelligence Committee’s Population Health Task Force has created a population health management model that identifies population health domains and capabilities, and maps nearly 500 functions to Value-Based Care (VBC) payment models. The model
- defines the pillars of population health management,
- identifies core functionality associated with each pillar, and
- distinguishes between essential and non-essential population health management capabilities for the various Value-Based Care payment models.
Like a Rubik’s cube, the capabilities and payment model grid is manipulatable, and can sort and filter across the domains, functions, and payment models to help you define the population health capabilities required when deploying a specific payment model.