Part B – Catcher or Pitcher?
Part B of this article addresses how growth plans of healthcare systems distinguish population health management from community and public health.
Part A of this article clarified the terminology and implications of Community, Public and Population Health. So what does all this this mean for healthcare system leaders’ growth plans?
Healthcare providers have historically played catcher, “receiving” patients who sought care. Access meant being available when and where patients sought them. The transition from volume-based care to population health management requires a role change of providers from catcher/receiver to pitcher/initiator. The transfer of utilization and intensity (and possibly actuarial) risk to providers requires providers to be economically accountable for care and the health of a population. The good news is that this is a better alignment with the societal view of healthcare as a service (in economics, a ‘good’ with a cost) that is necessary but not a value-add. The bad news for providers is that this is contrary to traditional culture and payment incentives. This change is not a transition, but a transformation that involves many transitions.
Is Less Healthcare Better?
From a community and public health perspective, success involves preventing disease and reducing the demand for healthcare services. Success for providers often means growth in healthcare services. Traditional revenue growth for providers involved price and quantity (P & Q). Providers feel conflicted: more P and Q meant economic success, but now, with increasing “value-based” care (more-risk, if not full risk), less P and Q means success.
Studies have called out pricing as the primary reason why costs in the U.S. are significantly higher than in other developed countries (Uwe Reinhart, ‘It’s the Prices Stupid’). Increasingly transparent societal forces are serving to limit growth in P. And the ascendance of population health management is serving to put downward pressure on Q – the quantity of health services provided. Read Full Article.