The Last Mile of Population Health Management

By Egor Kobelev and Daniel Piekarz

Egor Kobelev and Daniel Piekarz, executives in the Healthcare and Life Sciences practice at DataArt, take population health management to a practical level and discuss specific initiatives and key drivers of their successful implementation.

“Today there are several active initiatives and regulation provisions that could lead to even more fundamental changes in the U.S. healthcare system. The newest one is probably Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act of 2015 (MACRA), which strongly advocates for rewarding providers for providing better care, not just more care. Although MACRA looks very promising, it may be too early to discuss its practical implications. Much better examples are the Health Homes (HH) Program, launched in several states, and the Delivery System Reform Incentive Payment (DSRIP), originally introduced in California and later followed by Texas, Massachusetts, New Jersey, Kansas and New York.

Along with the other provisions, the ACA of 2010 created an optional Medicaid State Plan benefit for states to establish Health Homes and coordinate care for people with chronic conditions who have Medicaid coverage.

The greatest challenge is integrating a software solution into the organization’s unique software eco-system and harmonizing the data stored and updated within the organization with the data coming from the state. This task requires a deep understanding of the healthcare organization’s typical software setup including its practice management system, EHR, billing software as well as a solid knowledge of the way a state portal works, transmits and operates data.”

View original article here or download PDF.