As health systems look to boost their population health efforts, many struggle to build and sustain integral community relationships that could hold the key to their success, according to Modern Healthcare's quarterly CEO Power Panel Survey.
MH poll highlights what leaders want, where they're falling short
For the survey, Modern Healthcare polled 70 health care leaders and executives.
The survey found that more than 80 percent of respondents said their organization had a significant or total commitment to a population health strategy. Further, more than 70 percent of respondents said they screened consumers for risk factors tied to social determinants of health, such as food insecurity or homelessness. Moreover, 72 percent of organizations said they use EHRs to both screen for social determinants of health and assess the efficacy of their population health initiatives, while a separate 72 percent said they used insurance claims data for the same purpose.
But while health care leaders said they wanted to make headway on population health, about half of respondents cited partnership development or lack of community and patient input as the biggest barrier to addressing social determinants of health, Steven Ross Johnson writes for Modern Healthcare.
Further, according to the survey, health care leaders said while they value community partnerships as a way to address population health, they tended to focus within the industry when selecting a partners. Twenty-three percent of respondents said they sought to collaborate with other health care organizations, and 15 percent said they worked with health insurers.
When it comes to collaborating with community partners on population health initiatives, Hilary Heishman, senior program officer at the Robert Wood Johnson Foundation, explained, "The fact is, it requires real interpersonal relationships as opposed to business connections, or something that's more formalized." She added that health care providers who are looking at partnerships with groups outside the industry need to understand how their organization is perceived and address any negative perceptions.
For instance, Montefiore Health System in New York, which has incorporated population health into its business model and care delivery strategy for more than 20 years, currently ties more than 20 percent of its revenue to risk-based models. And according to Nicole Hollingsworth, assistant VP at Montefiore, that financial stake in keeping patients out of the hospital has helped foster trust between the organization and community stakeholders—and those relationships, in turn, have been critical to effective preventive care and wellness initiatives.
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Given the importance of those relationships, Hollingsworth said health systems should consider the relationships as part of the system's overall business strategy—not just a charitable endeavor or public relations gesture. "It has to be something you're invested in and something you're invested in over the long haul," she said.
For its part, Montefiore has been vigilant about maintaining those community relationships, Amanda Parsons, Montefiore's VP of community and population health, said. "I think one of the biggest fallacies in community work is assuming just because we're here that means we're partners with the community," Parsons said, adding, "Trust has to be gained for everything that we do."
Meanwhile, LifePoint Health, a health system based in Tennessee, has approached community partnerships by stating its objectives and expectations up front, according to CMO Rusty Holman, an approach that's enabled the health system to identify community stakeholders who have the same priorities. He characterized the system's approach to seeking community partners as presenting a "broad invitation" to range of entities.
And Cook County Health and Hospitals System in Chicago, has targeted population health through a partnership with the Greater Chicago Food Depository that brings fresh produce to food insecure patients throughout the city via a food truck. As of June, the program had delivered more than 138,000 pounds of produce to more than 5,100 people. Cook County Health and Hospitals System CEO Jay Shannon said, "We understand the need to develop strategies that become part of our everyday practice" (Ross Johnson, Modern Healthcare, 9/16).
Advisory Board's take
Population health leaders are increasingly investing energy and resources into addressing the social determinants of health. And for good reason: Non-clinical risk factors (e.g., housing insecurity, access to healthy foods) can have a greater effect on overall health than the quality of clinical care provided. When addressed effectively, hospitals measure significant cost savings in reduced utilization and avoidable readmissions.
The most resource-sustainable tactic for taking care of patients' non-clinical needs is partnering with community-based organizations that are already doing great work. The most innovative organizations are collaborating with community groups outside the traditional realm of health care: food pantries, congregations, housing agencies, and school districts.
But as the Modern Healthcare piece noted, many organizations are still having trouble establishing those community partnerships. That's why Advisory Board's Population Health Advisor created a guide to "Building the business case for community partnership."
In fact, the Modern Healthcare article eluded to three key must-dos we've learned in our research that make any community partnership successful:
- Define the concrete partnership objectives;
- Identify time, staff, and resource commitments that each partner is willing to make upfront; and
- Outline metrics and goals in advance to monitor the efficacy of partnership.
However, you can't rely on community partnerships alone to drive engagement with your hard-to-reach patients. You also need to start standardizing your cultural competency efforts now by providing language services, engaging community health workers, and hardwiring patient engagement techniques into the care team's workflow.