Population Health Management - An Alternative Approach
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Population Health Management - An Alternative Approach

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The healthcare system in United States, when compared to similar nations, is one of the costliest in the world with higher levels of healthcare spending, costlier hospital stays and higher prices of ...

The healthcare system in United States, when compared to similar nations, is one of the costliest in the world with higher levels of healthcare spending, costlier hospital stays and higher prices of prescription drugs. A major reason for the steady rise in the healthcare expenditure over the years has been the episodic treatment approach that has been prevalent in the US. The need of the hour is for health plans to adopt a more proactive approach. A Shift to Population Health Management (PHM) which is an altered approach, goes beyond episodic care by keeping a target population as healthy as possible. This White Paper covers HCL’s perspective on Care Management 2.0

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Population Health Management - An Alternative Approach Presentation Transcript

  • 1. Copyright © 2014 HCL Technologies Limited | www.hcltech.com White Paper Care Management 2.0 An Alternative Approach for Population Health Management
  • 2. 2 Copyright © 2014 HCL Technologies Limited | www.hcltech.com Rising Healthcare Costs in US has been a business challenge owning to inefficient and episodic treatment approach by US Health Plans Steady rise in healthcare cost • Episodic Treatment • Overprescribing of drugs and tests System Inefficiencies • Burdened by improper care and co-ordination • Complex administrative processes Unwanted Expenditures • Influx of new memberships from exchanges • Healthy population forgoing health insurance  The healthcare system in United States, when compared to similar nations, is one of the costliest in the world with higher levels of healthcare spending  Healthcare spending is expected to almost double within a decade2 (projected to grow from $2.8 Trillion in 2012 to $5 Trillion in 2022) (Source: National Healthcare Expenditure Projections 2012 – 2022 accessed at http://www.cms.gov/Research-Statistics)
  • 3. 3 Copyright © 2014 HCL Technologies Limited | www.hcltech.com There is a need for a push for Population Health Management; A Proactive approach adopted by Health Plans Health plans to adopt an approach that covers the members having chronic condition & extending the cover for preventive care - who have a tendency to develop chronic conditions Altered approach to healthcare which goes beyond episodic care by keeping a target population as healthy as possible The altered approach involves customizing the care modules for the particular patient Identify, activate and engage members Long term, continued Health promotion through Customized wellness and care initiatives Co ordinated effort of all stakeholders including members, Payers and Providers Ongoing measurement of progress across various indicators A successful PHM Program is built on Four Fundamental Pillars 1 2 3 4Health Situation Health Goals Behavior Patterns Ex. Pre-diabetic Vs Diabetic Ex. Prevent Chronic Condition v/s control chronic condition Ex. Actively manage own health v/s delays seeking care An Altered Approach
  • 4. 4 Copyright © 2014 HCL Technologies Limited | www.hcltech.com HCL’s Approach to Population Health Management is a 2 pronged approach addressing both existing and new members; Its time for Care Management 2.0 PHM Program for existing members by looking at Claims Data PHM Program as a comprehensive voluntary health risk assessment for new members HCL’s2prongedapproach HCLs Six Step Approach to Population Health Management(PHM) HCL’s PHM program measures multiple outcome parameters, which report on the progress across both the entire population and specific subpopulations.
  • 5. 5 Copyright © 2014 HCL Technologies Limited | www.hcltech.com A Shift to Care Management 2.0 DOWNLOAD THE WHITE PAPER TO UNDERSTAND HCL’s APPROACH TO CARE MANAGEMENT 2.0 The healthcare system in United States, when compared to similar nations, is one of the costliest in the world with higher levels of healthcare spending. A major reason for the steady rise in the healthcare expenditure over the years has been the episodic treatment approach that has been prevalent in the US. The need of the hour is for health plans to adopt a more proactive approach. A Shift to Population Health Management (PHM) which is an altered approach, goes beyond episodic care by keeping a target population as healthy as possible. This White Paper covers HCL’s perspective on Care Management 2.0 1. What is making healthcare cost rise in US? 2. What is the approach and a technology path that a Health Plan needs to adopt so as to stay profitable and customer friendly? 3. How can a technology service provider help me take an alternative route to reduce the rising healthcare costs? 4. HCL’s unique approach to Altered Population Healthcare Management (PHM) – Care Management 2.0 will help US health plans to emerge from this challenge of rising costs