Integrating Population Health Management into Your Strategic Plans

Marian C. Jennings, M.B.A. and Jennifer Swartz, B.A.


Many hospitals and health systems envision and embrace a future of population health management but face the challenge of “when to flip the switch from volume to value.” Today, more effectively managing congestive heart patients may be the right thing to do, but it may negatively impact revenues and the bottom line. Tomorrow, it may be a financial imperative.  Additionally, organizations are struggling to leverage the data they already have to support evidence-based decision making for not just an individual patient but a population of patients.


Despite these challenges, however, the steady movement toward alternative payment models is accelerating— so how can health care organizations prepare?


The first step in incorporating population health management initiatives into a strategic planning process is to determine your organization’s market stance—or how it goes about realizing its vision. An organization’s market stance will depend on a combination of factors, the degree of uncertainty facing its particular market, the amount of risk it is willing/able to undertake, its culture, and its strategic position and capabilities—including its financial strength/capabilities.


M. Jennings Consulting stratifies strategic intent along three “Boards of Play,” which describe three levels of risk associated with enacting an organization’s vision.


Board 1: “No-Regrets Moves”


A Board 1 strategy, or “no-regrets move,” is a lower-risk strategy focused on enhancing performance based upon the rules in place today. For example, Medicare has created financial incentives, and downside penalties, related to its value-based purchasing program. A “no-regrets” move would be to focus on performing exceptionally well against the clinical outcomes, patient experience, and other domains both in place today and those planned for the next several years. This way, the hospital will earn the maximum financial bonus and will also learn how to adapt when payment approaches change . . .


Board 2: “Hedge Your Bets”


A good Board 2 or “hedge your bets” strategy allows the organization to learn about different “new rules” without a long-term, major commitment. This enhances the organization’s agility as the market evolves. Some examples of hedged-bet strategies for population health management include:


  • Seek demonstration grants to “experiment” in population health management without assuming full financial risk.
  • Experiment with payment bundling for certain services (e.g., ortho, cardiac); or perhaps to participate in a Medicare Shared Saving Program.
  • Develop and learn from a “mini-ACO” for your own employees.
  • Develop highly desirable physician employment models and infrastructure to prepare for an era of population health management, but be very selective about employment.
  • Strengthen alignment, short of merger, with key parties—including area hospitals, FQHCs or community health centers, vertical integration players (e.g., home care), and potential tertiary care ACO partners.


Board 3: “Big Bet”


A Board 3 or “big bet” strategy is visibly risky.  If the market does not evolve as expected, it can be disastrous. We went through this in the 1990s with catastrophic results when some health systems moved too quickly toward a future of population health based payments, which then never materialized.  Some Board 3 examples for population health management might include:


  • Actively pursue risk contracts for managing population health with Blue Cross or major insurer.
  • Buy or build your own health plan.
  • Move from pluralistic medical staff to fully employed physician staff (e.g., mini-Geisinger model) as quickly as possible.
  • Actively seek a merger with another local community hospital to create greater critical mass of patients/population to support population health management.
  • Create an exclusive referral relationship with a large regional health system (and participate in its population health management initiatives/ACO development; develop seamless EHR interface or install their system, etc.)
  • Pioneer at-risk or other value-based contracts in your market.


iProtean subscribers can read the full article in the upcoming course, Integrating Population Health Management into Your Strategic and Financial Plans, Part One. Marian Jennings is one of the expert presenters in the course, which is being readied for publication.


iProtean thanks Marian Jennings and Jennifer Swartz for submitting this article for publication with our population health management courses and for this blog newsletter.




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