Almost 332 million people live in the United States, 75 percent of whom are adults. With roughly 497,000 primary care physicians (PCPs) in this country — and a shortage expected to continue — it’s nearly impossible for doctors to provide personalized care to each individual without the patients’ participation. If the population was divided equally, that means each PCP would be responsible for about 668,000 patients.
Under the previous fee-for-service (FFS) model, in which doctors are paid for each service performed, there was little incentive to deliver efficient care or prevent unnecessary care. With the transition to value-based care (VBC), physicians are rewarded with incentive payments for the quality of care they provide. One of the primary reasons this new model was introduced was to reduce national health expenditures. According to the Centers for Disease Control & Prevention (CDC), U.S. healthcare spending is now at $4.1 trillion — that’s about $12,530 per person.
Under value-based care, the implementation of population health programs is especially beneficial because they’re designed to improve clinical metrics for specific groups of patients. This can be achieved through population health management (PHM), to which the American Hospital Association (AHA) refers as “the process of improving clinical health outcomes of a defined group of individuals through improved care coordination and patient engagement supported by appropriate financial and care models.”
The goal of PHM is to proactively tackle health disparities and keep patients healthy outside their care visits. For what reason? To minimize costly interventions, including emergency department visits, hospitalizations, imaging tests and surgery. Preventive care is an integral component of value-based care, and healthcare providers can utilize population health management efforts to focus on it.
The Correlation Between Patient Engagement and Population Health
With that staggering ratio of about 668,000 patients per U.S. PCP, it’s essential for patients striving for better health outcomes to participate in their own care. Hence, that oh-so-often discussion about patient engagement.
This term might sound like just another healthcare buzzword, but it’s a crucial part of individuals actively participating in medical care, prevention and maintenance of positive long-term health habits. This type of engagement consists of access to care, patient-provider communication, remote patient monitoring, chronic disease self-management and other similar concepts.
A key component of patient engagement is education. Physicians should not only provide patients with basic health information but also that which is relevant for and useful to them. It’s utilizing data to tailor healthcare to those patients and empowering them to actively participate in their care and engage in shared decision-making.
What, then, does patient engagement have to do with population health? A lot! Meaningful population health management programs producing solid results can only be achieved with strong patient engagement. Both are extremely impactful in the transition to value-based care.
Proactive patient engagement strategies drive population health goals and promote better health outcomes by encouraging patients to adhere to their recommended care. It enables healthcare providers to more easily identify patients who are at risk for chronic diseases management and offer them the resources to improve their outcomes. Research has found that patients who feel more connected to their care are more likely to follow recommended treatment plans, which drives better outcomes.
Combining patient engagement with PHM also allows providers to customize their care for those patients using an approach based on their preferences and social determinants of health (SDOH). Studies show that personalization is very important to healthcare consumers, and it improves their trust in healthcare providers, increases retention rates and boosts population health outcomes.
Providers should communicate with their patients in ways that are relevant and personalized to each individual. Whether it’s an appointment reminder that addresses them by name or a follow-up message via text after their appointment, these communications are personalized and will help patients feel cared for and engaged in their health. Another part of personalized provider-patient communication is making it convenient, especially as the healthcare consumerism trend continues to expand. Patients want — and expect — access where and when it’s most convenient for them.
How Digital Technology Promotes Patient Engagement
Automated technology enables providers to deliver relevant and valuable messages at scale while still maintaining a personal level of communication. For instance, a well-designed patient engagement platform reduces administrative burden while automatically managing routine patient education and communication. Such technology enables providers and their staff to communicate across the entire patient care journey.
Patient engagement platforms also consider the underlying factors that often inhibit people from practicing healthy habits, information from which communications and other outreach campaigns can be designed to motivate patients to take positive actions for their health. By proactively engaging more patients, providers can promote shared decision-making, track key health metrics and enable patients to reach out to their doctors when they have questions or concerns.
To offer the convenience patients prefer, digital patient engagement solutions should make it easy for them to schedule appointments, access patient education information, properly prepare for tests and procedures and pay medical bills online. Some technology even has the capability to safely reduce inpatient stays through proactive monitoring. All these advantages help create the necessary components of population health management.
A prime example of a digital health tool that promotes patient engagement — while contributing to population health management — is HIPAA-compliant two-way text messaging. With this technology, providers can easily and securely send patients automated text messages to nudge them about an upcoming appointment and remind them of their care plan guidelines. In a group of studies involving 2,742 patients with a range of chronic conditions, interventions via text message doubled the odds of medication adherence, raising the rate of adherence to 67.8 percent.
Any such technology solution, however, should also reduce the administrative burden for both physicians and their staff. If not, they will only exacerbate the already high prevalence of physician and nurse burnout.
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