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    Health plan executives' top population health priorities

    We asked four health plan executives what their organizations are doing to make the most of population health management. Here's what they said.

    Independence Blue Cross - Donald Liss, MD, vice president for clinical programs and policy at Independence Blue Cross, the largest health insurer and managed care organization in the Philadelphia region.

    Managed Healthcare Executive (MHE): What are some of the most exciting population health management initiatives taking place at your organization?

    LissLissLiss: Over the last decade, Independence Blue Cross has moved from a centralized approach aimed at direct outreach to our members mainly through call centers, to organizing our networks (doctors and hospitals) to include population health management as a fundamental component of their work.

    In addition, our role has expanded to leverage the valuable patient information we collect in the ordinary course of our operations, such as claims and lab data, and making this available at the point of care to physician practices and health systems that have become accountable for clinical and financial outcomes.

    Further, we are aligning our benefit designs to create incentives for our members to be more receptive and engaged in their own care. If we do our job right, our payment models, our information resources, and our plan designs will mutually reinforce one another.

    MHE: What are some of your population health management plans for 2016?

    Liss: Promoting our High Value Care program is a top priority for 2016. This program identifies specific opportunities for primary care physicians in our network to address identified gaps in care, and to do that in the most cost-effective ways.

    These doctors are eligible to receive significantly enhanced payment for their efforts.  Primary care practices also are eligible for financial incentives for team-based care that helps deliver better results across the populations they serve.

    We regularly provide clear, actionable reports as well as point-of-care messaging to doctors, which integrates population health management into their everyday activities.

    We continue to champion the Patient-Centered Medical Home as a durable model of care and the foundation for an accountable healthcare system.

    MHE: What are your top population health management tips for healthcare executives?

    Liss: Population health needs to be an integral part of the physician’s business; it can’t be a separate exercise relegated to the quality management department. If population health management isn’t reinforced in how we compensate doctors, how we provide information, and how we design benefits, it will always be a stepchild.

    Next: CareSource's population health priorities

     

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