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Population Health Management Creates Need for New Roles in Healthcare

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In an era of healthcare reform, hospitals and health systems have begun the journey to transform the way care is delivered. In the future, providers will be held accountable for both the cost and quality of care they provide and for improving the overall health status of specific populations. These changes will require new capabilities and ways of thinking, economic models that reimburse providers in different ways, and management skills that encourage innovation and align clinical and operational resources to improve outcomes and efficiency. In order to be successful and sustainable, organizations will need a well-developed and defined population health strategy as part of their overall strategic plan.

Although the concept of population health is not new, the actual development, execution and implementation of an effective strategy can present a daunting and complex task to any health system. As the traditional fee-for-service model is turned up-side-down in exchange for a value-based reimbursement model, there are enormous cultural, strategic, operational and economic implications that must be considered. To complicate matters, there remains a high degree of uncertainty as to how this paradigm shift in the industry will evolve, and, in addition, each market will have its own unique set of circumstances and challenges that must be addressed. The industry is experiencing a period of change like no other, which requires a new way of thinking and a new bag of tools for the C-suite. As organizations continue to navigate healthcare reform, the chief population health officer (CPHO) is emerging as a critical new position.

To accomplish the goals of a successful population health program, health systems must initiate a variety of tasks. These systems need to establish a capable and qualified workforce to support care management, provide health information technology and translatable data to track health trends for targeting at-risk populations, and develop a solid organizational structure that includes strong backing from senior hospital leadership, clinician engagement/buy-in, formalized community partnerships, and aligned payer and provider strategies.

Tasked with leading the development and implementation of a health system's population health initiatives, the CPHO plays a role that varies from system to system. Variables such as market needs, scale, complexity, IT systems, data analytic capabilities, physician networks, and externalities in terms of community partners and payers are all factors in determining the challenges a CPHO will face and the skill sets that are required. Additionally, where an organization is on its population health journey and how robust and developed each of the key components are is a significant determining factor in the type of profile that will be most ideal. It has been our experience that client organizations tend to fall into three distinct categories: 1) those in the early stages of development where internal capabilities, processes, resources, networks and payer strategies must be established and defined; 2) those where the essential building blocks are in place but a heftier strategy is needed to pull all of the components together in a more concerted and effective way; and 3) the early adopters who have a robust integrated delivery model, their own health plan, a solid IT platform, and existing risk contracts representing a wide variety of pay for value models.

Regardless of where an organization is on its population health journey, one thing is certain—the CPHO is a crucial member of the senior leadership team, and organizations cannot use a "one size fits all" approach in recruiting for a CPHO. Understanding an organization's opportunities and challenges, internal resources and systems, internal talent pool and capabilities, and external market forces are all critical first steps in defining a population health strategy and the appropriate type of leader to guide that initiative.

For more information on how Quick Leonard Kieffer can assist your organization in a search for population health executives, please contact Zack Reynolds, Partner, at 312-876-9800 or zreynolds@qlksearch.com. 

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