When it comes to healthcare innovation, much of the conversation in the industry centers on population health.
For many in our field, population health is the shining star of the future of healthcare. But the massive shift it will take to make it a reality means it will be slow going—at least, without more focus on advanced primary care.
Population health: early successes
At Vera, we’re already seeing big successes through population health.
As Ryan Schmid, Vera President & CEO shares, “We analyze two years' worth of claims data to uncover areas where we can make the greatest impact.” That information is vital, because it is how Vera works with our partners to build teams of care providers suited to each specific population.
“The reason we've been so successful at managing care for specific populations is our ability to hire an entire care team and set up an entire care center dedicated to one population of people,” Schmid explains.
The next step: advanced primary care
But one of the keys to successfully implementing population health is advanced primary care.
Just like population health uses data at the community level, advanced primary care uses data to deliver better care to individual patients.
In an effective population health environment, advanced primary care offers the right care team to manage and coordinate services that are specifically tailored to the patients who will need them.
When you know the care population, the risks, and the potential rewards, it’s easier to establish a primary care system to meet those needs. Advanced primary care helps answer questions like:
What kind of care should a clinic provide?
What kind of disciplines and specialties are needed for a primary care team?
Is worker’s comp a significant concern?
Will a large portion of the population need physical therapy?
How frequent will the phlebotomy needs be?
When we understand the care population, we can answer all these questions and more. As a result, teams can be trained and equipped to manage patient care effectively.
Providers are responsible for the care of every patient, whether the services are performed onsite or require a referral. Think of primary care providers (and the entire clinical support team) as coordinators, guiding their patients along on their health journeys. Medical decisions and planning take place within this context.
What are the results?
In short, less waste and fewer gaps. When primary care is done right, building rapport and relationships with patients, planning and guiding their health plan, coordinating their care, and following up, there’s little need for:
Urgent care visits
Unnecessary trips to the ER
Specialists providing what primary care is trained to do
But more than less waste and fewer gaps, the patient has a better and more convenient care experience.
This is especially true with advanced primary care, where providers are operating at the top of their medical licenses, and are able to provide a higher level of services —services that, in a less effective system, are often unnecessarily handed off to specialist.
Wraparound care is the goal
Imagine a system where providers and care teams support the patient with outreach, longer appointment times, health coaching, an integrated pharmacy, and follow-up support to help them follow care plans.
That's not a fantasy; it's an approach called wraparound care.
Providers and care teams use data to eliminate gaps in care, so that the patient's health plan essential "wraps around" them from the first interaction. And because of the centrality of primary care, any specialist care funnels back through the care provider and team, closing the loop and ensuring that results are reflected in the whole care plan.
Sue Ferbet, Vera’s Chief Clinic Operations Officer says, “So often, people come in with all of their information from Google and WebMD. Many times, they've already decided what they have. Our job as healthcare providers is to talk to them about the information that they found on their searches, talk to them about what we have seen in our evidence-based practice, and then, together with that patient, make the right decision for them. Oftentimes it’s a much less costly opportunity.”
All of this enables the patient to continue a relationship with their primary care provider. And it delivers cost savings on specialty referrals without sacrificing exceptionally high quality care.
At Vera, we want to provide that kind of care not just to individual patients, but to whole communities via population health management. And while it may take a massive shift for the industry as a whole to make population health a reality, it can be implemented much more quickly for smaller, defined groups.
In the end, everyone wins. But it goes back to who the patient and population are, what their needs are, and how to build a team with the right skills and training to care for them.